继美兆与温教授合作研究慢性肾脏病(CKD)议题获刊 The Lancet国际知名医学杂志的新闻稿之后，这项研究成果又获得美国华盛顿邮报与英国路透社报导。美兆健康管理数据库的学术研究价值，受全球媒体重视。

Epidemiology

Chronic kidney disease a common cause of premature death

Last Updated: 2008-06-26 18:30:20 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Chronic kidney disease - even in early stages - is responsible for a substantial proportion of deaths that occur before age 65, according to a prospective study in Taiwan published in the June 28 issue of The Lancet.

"Chronic kidney disease can be ranked as one of the most preventable risk factors (for early mortality) worldwide," lead author Dr. Chi-Pang Wen and his colleagues state.

Dr. Wen, at the National Health Research Institutes in Zhunan, Taiwan, and associates calculated the mortality risks for all five stages of chronic kidney disease (CKD) based on a cohort of nearly half a million nominally healthy adults who underwent medical screening between 1994 and 2006.

They estimate that the national prevalence of CKD was 12%. Disease in stages 3-5 (glomerular filtration rate no greater than 59 mL/min/1.73 m²) accounted for 60% of the total prevalence. National prevalence ranged from 5.2% among subjects ages 20-24, to 37% among subjects 65 years old and older.

The prevalence was nearly three times higher in those with low socioeconomic status (based on achieving less than a high-school education), the report indicates.

What's more, "nearly all participants with CKD were unaware of their disorder until they were in later stages."

The attributable fraction for all causes of death due to CKD in the total study population was 10.3%, but 17.5% among those in the lowest socioeconomic status. Even slight proteinuria was associated with significantly increased mortality. Death occurred before age 65 in 39% of subjects with CKD.

The investigation revealed that regular use of Chinese herbal medicines was an independent risk factor for overall CKD and for severe CKD.

"The underdiagnosis and undertreatment of chronic kidney disease is universal," Dr. Wen's group concludes, "and...the lack of awareness of the problem or the lost opportunities for prevention is a global one."

Their recommendation: "The general public, by knowing their glomerular filtration rate and testing their urine, can take the necessary first step to reduce associated risk factors and to attenuate the increasing rate of this disease."

Lancet 2008;371:2173-2182.



引用：http://www.washingtonpost.com/wp-dyn/content/article/2008/06/26/AR2008062603309.html

Chronic Kidney Disease Growing Globally

Thursday, June 26, 2008; 12:00 AM

THURSDAY, June 26 (HealthDay News) -- The already high worldwide rate of chronic kidney disease (CKD) is increasing, and the fact it raises a person's risk of death should make the disease a public health priority, say Taiwanese researchers.

They analyzed data on 462,293 people in Taiwan over age 20 who took part in a standard medical screening program in 1994. The participants were observed for 13 years, with a median follow-up of 7.5 years.

The 56,777 (12 percent) people with CKD were 83 percent more likely to die from all causes and twice as likely to die from cardiovascular causes than those without CKD, the study found. Almost 40 percent of deaths in the CKD group occurred before age 65.

Of the deaths in the entire study group, 10.3 percent were attributable to CKD, but this figure increased to 17.5 percent among people with low socioeconomic status. The rate of CKD was higher among people with low socioeconomic status (19.8 percent) than among those with high socioeconomic status. Of those with CKD, only 3.54 percent were aware of their condition. In the United States, that figure is 10 percent.

Interestingly, the researchers also found that people who regularly used Chinese herbal medicines had a 20 percent increased risk of developing CKD.

The number of people in the study affected by CKD was several times more than that for diabetes, and more than half the number affected by high blood pressure.

The study was published in this week's issue ofThe Lancet.

Under diagnosis and under treatment of CKD is a worldwide issue, the researchers said.

"The high prevalence and its associated all-cause mortality, especially in people with low socioeconomic status, make reduction of CKD a public health priority. Promotion of its recognition through the general public knowing their GFR [glomerular filtration rate] and testing their urine is crucial to reduce premature deaths from all causes and to attenuate this global epidemic," the study authors concluded.

More information

The National Kidney Foundation has more about chronic kidney disease.

SOURCE:The Lancet, news release, June 27, 2008