T2DM优选脏安全性高的降糖药物原则.ppt

* * * 左边这是一项抽样调查全国13个省市自治区的横断面研究，研究对象为18岁以上一般人群，抽取样本量为47204例，慢性肾脏病定义为eGFR60ml/min/1.73m2和/或白蛋白尿。结果显示中国慢性肾脏病患病率为10.8%，据此估计中国成人中有1.2亿慢性肾脏病患者，其中知晓率仅12.5%。 右边是美国一项全国性的横断面调查研究——肾脏早期评估项目(KEEP研究)的结果，该研究共调查77077名受试者，其中23082例诊断为糖尿病患者，糖尿病患者中7853例合并CKD，患病率为34%，但仅9.4%的患者(736例)知晓患有CKD。 这两项研究表明，无论是在一般人群，还是在2型糖尿病患者中，CKD患病率都比较高，但知晓率却很低。 * * Am J Kidney Dis. 2008 Aug;52(2):382-3. CKD Awareness in the United States: The Kidney Early Evaluation Program (KEEP) Chronic kidney disease (CKD) is silent until advanced stages and therefore many individuals are unaware of its presence and detection often occurs only shortly before onset of symptomatic uremia. Thereby, awareness and detection of CKD at earlier stages would allow more time for evaluation and treatment. The Kidney Early Evaluation Program (KEEP) is the first national health screening program to target adult populations at high risk for CKD and promote awareness. Previous population-based surveys have suggested that most patients with CKD have not effectively been informed of their condition by their medical professional. [1] and [2] Unlike KEEP, these surveys were not designed to specifically target patients at risk for CKD. We sought to determine how many patients identified as having CKD through the KEEP screening had been told by a physician they had kidney disease prior to screening and advised to follow its progress. The KEEP methods, including CKD definition, have been described previously. [3] and [4] Data were examined from August 1, 2000 to December 31, 2005. While most (90%) patients found to have CKD had seen a physician within the previous year, awareness of kidney disease was low for all stages of CKD (Table 1). We then examined CKD awareness pre-2003 and compared it to 2003 and onwards. For CKD stages 1 to 3, awareness increased slightly (4.1% [95% confidence interval (CI), 3.4% to 4.9%] versus 5.5% [95% CI, 5.0% to 5.9%, P 0.01]), while awareness for CKD stages 4 to 5 had a more profound increase (19.7% [95% C