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关于慢性肾病

肾脏是身体中最繁忙的器官之一，其中100万个微小过滤器（称为肾单元）共同过滤血液，将废物和多余液体转化为尿液。1肾功能在比较缓慢的过程中进行性丧失被称为慢性肾病（CKD）。2   

CKD在全球各地都非常流行，影响着全球约8.5亿人，占总人口的10%以上3,4。由于CKD在疾病晚期之前大多是无症状的，因此大多数患者未被诊断，每年有数百万人过早死于CKD及相关并发症3。

CKD的病因是什么？   

CKD可能发生在任何年龄段，但是某些人群的患病可能性更高。5约三分之一的CKD病例是由糖尿病和肥胖等代谢性疾病造成，但风险最高的人群还包括有CKD家族史或高龄人群。6,7,8

CKD有哪些症状？9

大多数病例无症状，但随着肾脏损害的加重，症状可能包括：

  • 疲劳
  • 脚踝、脚或手肿胀
  • 呼吸短促
  • 感觉难受
  • 血尿
  • 皮肤瘙痒

如何诊断CKD？

血液检查使用一种称为肾小球滤过率估计值（eGFR）的指标检查肾脏滤过血液的速度。
尿液检查用于检查尿液中的白蛋白和肌酐，称为白蛋白/肌酐比值（UACR）。
高血压、糖尿病和心血管疾病患者人群罹患CKD的风险较高，因此应根据指南建议对这些人群进行筛查。10

 

参考文献

[1] National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Your Kidneys and How They Work. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work#:~:text=Your%20kidneys%20remove%20wastes%20and,and%20potassium%E2%80%94in%20your%20blood. Last accessed: October 2022.
[2] Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6(13):1246–58.
[3] Levin A, Tonelli M, Bonventre J, et al. Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy. Lancet. 2017;390:1888-917.
[4] Coresh J. Update on the Burden of CKD. J Am Soc Nephrol. 2017;28(4):1020–1022.
[5] National Kidney Foundation. Chronic kidney disease. Available at: https://www.kidney.org/atoz/content/about-chronic-kidney-disease. Last accessed: October 2022.
[6] Yim HE, Yoo KH. Obesity and chronic kidney disease: prevalence, mechanism, and management. Clin Exp Pediatr. 2021;64(10):511-518.
[7] Levin A, Tonelli M, Bonventre J, et al. Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy. Lancet. 2017;390:1888-917.
[8] Wang V, et al. LE. Semin Nephrol. 2016;36(4):319-30
[9] NHS: Chronic Kidney Disease. Available at: https://www.nhs.uk/conditions/kidney-disease/. Last accessed: October 2022.
[10] NHS: Chronic Kidney Disease. Diagnosis. Available at: https://www.nhs.uk/conditions/kidney-disease/diagnosis/. Last accessed: October 2022.
 

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慢性肾病