慢性肾脏病的全球影响

G. Modi, V. Jha
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摘要

慢性肾脏疾病在世界范围内具有高患病率和高死亡率。虽然糖尿病和高血压很常见,但肾脏疾病的独特原因可能由感染、暴露或遗传易感性引起。在某些农业地区,病因不明的肾小管间质性肾病的发病率尤其高。危险因素可能包括热应激、杀虫剂、重金属和其他环境毒素。此外,各国在肾脏替代疗法的流行程度上存在着不成比例的差异,这似乎在一定程度上与医疗保险的类型有关。全球肾脏病学界未来的挑战将是应对越来越多的终末期肾病患者,一些国家医疗保健的碎片化,肾移植项目的短缺,以及缺乏适当评估肾脏疾病流行的登记。本综述包含4张图,3张表,54篇参考文献。关键词:急性肾损伤,慢性肾病,终末期肾病,流行病学,种族背景,hiv相关肾病,非传染性疾病,肾脏替代治疗,筛查,社会经济地位
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Global Aspects of Chronic Kidney Disease
Chronic kidney disease has a high prevalence and a high mortality rate worldwide. Although diabetes and hypertension are common, unique causes of kidney disease may occur driven by infections, exposures, or genetic susceptibilities. Certain agricultural areas in particular have a high incidence of tubulointerstitial kidney disease of unclear etiology. Risk factors may include heat stress, pesticides, heavy metals, and other environmental toxins. Furthermore, countries have disproportionately different prevalence of renal replacement therapy, which seems to correlate in part to the type of health coverage. The future challenges for the nephrology community worldwide will be dealing with the growing number of patients with end-stage kidney disease, the fragmented healthcare in some countries, shortage of kidney transplantation programs, and deficient registries to appropriately assess the prevalence of kidney disease. This review contains 4 figures, 3 tables, and 54 references. Key Words: acute kidney injury, chronic kidney disease, end-stage renal disease, epidemiology, ethnic background, HIV-associated nephropathy, noncommunicable diseases, renal replacement therapy, screening, socioeconomic status
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