“一带一路”国家慢性肾脏病的疾病负担及变化趋势研究  

Disease burden of chronic kidney disease and change trend in Belt and Road countries

作　　者：李阳 王一梅 李芳 沈波 丁小强 方艺[1,2,3,4] Li Yang;Wang Yimei;Li Fang;Shen Bo;Ding Xiaoqiang;Fang Yi(Department of Nephrology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Clinical Research Center of Kidney,Shanghai 200032,China;Shanghai Key Laboratory of Kidney and Blood Purification,Shanghai 200032,China;Shanghai Institute of Kidney and Dialysis,Shanghai 200032,China;Department of Nephrology,Zhongshan Hospital(Xiamen),Fudan University,Xiamen 361006,China)

机构地区：[1]复旦大学附属中山医院肾内科,上海200032 [2]上海市肾脏疾病临床医学研究中心,上海200032 [3]上海市肾脏疾病与血液净化重点实验室,上海200032 [4]上海市肾病与透析研究所,上海200032 [5]复旦大学附属中山医院厦门分院肾脏科,厦门361006

出　　处：《中华肾脏病杂志》2024年第5期335-344,共10页Chinese Journal of Nephrology

基　　金：国家自然科学基金青年项目(82103911);上海市长三角科技创新共同体领域项目(21002411500);上海市肾脏内科联盟项目(SHDC2202230)。

摘　　要：目的分析2019年“一带一路”国家慢性肾脏病(chronic kidney disease,CKD)的疾病负担及纵向变化趋势。方法这是一项基于监测数据的横断面流行病学研究。CKD年龄标准化患病率(age⁃standardized prevalence rate,ASPR)和年龄标准化死亡率(age⁃standardized mortality rate,ASMR)数据来源于2019年全球疾病负担研究数据库,计算年度变化百分比(annual percentage change,APC),分析CKD的ASPR在1990—2019年的变化趋势。结果2019年,153个“一带一路”国家的CKD患病和死亡人数分别为4.26亿和79.8万,分别占全球的61.1%和55.9%。中国的ASPR和ASMR分别为8.1%和11.2/10万,略低于全球平均水平(8.6%和18.3/10万)。北美洲和大洋洲“一带一路”国家的CKD疾病负担较高,欧洲的CKD疾病负担较低。高血压和糖尿病相关的CKD患病和死亡数分别占全部CKD病因患病和死亡数的23.7%和68.8%。从1990年至2019年,150个国家(98.0%)CKD的ASPR呈上升趋势,上升速度最快的国家是摩洛哥(APC=1.52%)。空间热点分析显示,CKD的ASPR热点区域集中于亚洲、北美洲、南美洲和大洋洲,CKD的ASMR热点区域集中于非洲、北美洲、南美洲和大洋洲。“一带一路”国家的社会人口指数和期望寿命与CKD的ASPR呈正相关(r=0.409,P<0.001;r=0.361,P<0.001),与CKD的ASMR呈负相关(r=-0.317,P<0.001;r=-0.391,P<0.001)。结论“一带一路”国家CKD疾病负担严重,且患病率上升速度快。未来需加强成员国之间的卫生合作,以共同应对CKD等慢性疾病带来的挑战。Objective To analyze the disease burden of chronic kidney disease(CKD)in the Belt and Road countries and its change trend.Methods It was a cross-sectional epidemiological study based on surveillance data.Data on age-standardized prevalence rate(ASPR)and age-standardized mortality rate(ASMR)of CKD were derived from the 2019 Global Burden of Disease Study.The annual percentage change(APC)was calculated to evaluate the ASPR trend of CKD from 1990 to 2019.Results In 2019,the number of CKD cases and deaths in the Belt and Road countries was 426 million and 798000,respectively,accounting for 61.1%and 55.9%of CKD cases and deaths worldwide.The ASPR and ASMR of CKD in China were 8.1%and 11.2 per 100000 population,slightly lower than the global average.Countries in North America and Oceania had a higher burden of CKD,and European countries had a lower burden.In the etiology,hypertension and diabetes-related CKD morbidity and mortality accounted for 23.7%and 68.8%of total CKD morbidity and mortality,respectively.From 1990 to 2019,the ASPR of CKD increased in 150 countries(98.0%)and the fastest increase was observed in Morocco(APC=1.52%).The hotspots with high ASPR of CKD were located in Belt and Road countries from Asia,South/North America and Oceania,and the hotspots with high ASMR were distributed in countries from Africa,South/North America and Oceania.The sociodemographic index and life expectancy were positively correlated with the ASPR of CKD(r=0.409,P<0.001;r=0.361,P<0.001),and negatively correlated with the ASMR of CKD(r=-0.317,P<0.001;r=-0.391,P<0.001).Conclusions Belt and Road countries have substantial disease burdens of CKD,and the prevalence rate of CKD is rising fast.Health cooperation among member states should be strengthened to jointly address the challenges posed by chronic diseases such as CKD.

关 键 词：肾功能不全 慢性 患病代价 患病率 死亡率 一带一路 

分 类 号：R692[医药卫生—泌尿科学]