1990—2021年我国慢性肾脏病疾病负担及其危险因素分析

An analysis of disease burden and risk factors of chronic kidney disease in China from 1990 to 2021

目的研究1990—2021年我国慢性肾脏病(chronic kidney disease,CKD)疾病负担的现状与趋势,为制定CKD防控政策提供科学依据。方法数据来源于2021年全球疾病负担研究,采用发病、死亡和伤残调整寿命年(disability-adjusted life year,DALY)指标对比分析我国CKD及其亚型疾病负担现状,并采用年估计变化百分比(estimated annual percentage changes,EAPC)评估疾病负担的时间趋势。结果2021年我国CKD年龄标化发病率为163.74/10万,年龄标化死亡率为10.84/10万,年龄标化DALY率为315.33/10万。1990—2021年CKD年龄标化发病率呈上升趋势[EAPC=0.52%,95%CI(0.44,0.59)],年龄标化死亡率[EAPC=-0.90%,95%CI(-0.98,-0.81)]和年龄标化DALY率[EAPC=-1.25%,95%CI(-1.35,-1.16)]总体均呈现下降趋势。CKD疾病负担呈现明显的性别、年龄特征,其中女性发病率高于男性,而死亡率和DALY率低于男性,CKD疾病负担随年龄呈上升趋势,60岁以上人群具有较高的疾病负担。CKD疾病负担主要来源于2型糖尿病肾病和高血压肾病,高血糖、高BMI和高血压是其主要的危险因素。结论我国CKD疾病负担较重,并且在不同年龄段和性别中存在显著差异。因此,有必要进一步优化和实施三级防控策略,从关键人群和主要危险因素着手,以有效降低我国CKD的整体疾病负担。

Objective To investigate the current status and trends of chronic kidney disease(CKD)burden in China from 1990 to 2021,and to provide scientific evidence for the formulation of CKD prevention and control policies.Methods Data were sourced from the 2021 Global Burden of Disease Study.The burden of CKD and its subtypes in China was analyzed using incidence,mortality,and disability-adjusted life years(DALY)metrics.The estimated annual percentage change(EAPC)was used to assess the temporal trends.Results In 2021,the age-standardized incidence,mortality and DALY rates of CKD in China were 163.74 per 100,000,10.84 per 100,000 and 315.33 per 100,000,respectively.From 1990 to 2021,age-standardized incidence rate of CKD showed an upward trend[EAPC=0.52%,95%CI(0.44,0.59)],while agestandardized mortality rate[EAPC=-0.90%,95%CI(-0.98,-0.81)]and age-standardized DALY rate[EAPC=-1.25%,95%CI(-1.35,-1.16)]showed downward trends(EAPC<0).The burden of CKD exhibited significant gender and age characteristics,with higher incidence rates in females compared to males,but lower mortality and DALY rates in females.The burden of disease for CKD tends to increase with age,with a higher burden of disease in people over 60 years of age.The primary contributors to CKD burden were CKD due to diabetes mellitus type 2 and hypertensive renal disease,for which high fasting plasma glucose,high BMI and high blood pressure were the main risk factors.Conclusion The burden of CKD is high in China and varies significantly across age groups and gender.Therefore,it is necessary to further optimize and implement a tiered prevention and control strategy,starting from the key populations and major risk factors,and commit to effectively reducing the overall disease burden of CKD in China.