Abstract
Chronic kidney disease (CKD) is a common disorder that often occurs as a complication
of other common diseases such as diabetes, obesity, hypertension, or heart failure.
Here we review the methodological pitfalls both in measuring kidney function and in
determining the epidemiology of kidney disease. CKD is defined as the coincidence
of three criteria: A reduced glomerular filtration rate, an anatomical lesion, and
a duration of more than three months. Glomerular filtration rate declines with increasing
age, but this alone does not constitute kidney disease. In epidemiological studies,
exact measurement of glomerular filtration rate is often not feasible. Estimates of
glomerular filtration rate depend on serum levels of creatinine or cystatin C, both
of which are influenced by extrarenal factors. Anatomical lesion and duration of disease
are almost never ascertained in epidemiological studies. Somewhat surprisingly, large-scale
statistical modeling by the Global Burden of Disease Study suggests a decline in the
world-wide prevalence of CKD in the past decades. In Germany, no longitudinal data
is available for lack of a national register. Cross-sectional investigations report
prevalences between 6 and 26 percent, depending on age, comorbidities, and geographical
region. In the future, better control of risk factors may precede a decline in the
incidence of CKD, with prevalences remaining stable due to better medical care and
improved survival. In the long run, there is reason to believe that there will not
be ever more patients with CKD.
Chronische Niereninsuffizienz ist häufig eine Folge von Diabetes, Adipositas, Hypertonie
oder Herzinsuffizienz. Jahrelang stiegen die Erkrankungshäufigkeiten. Valide Messungen
der Prävalenz chronischer Nierenerkrankungen sind aber nur schwer zu erhalten, und
die vorhandenen Daten legen – etwas überraschend – für die letzten Jahre eher eine
Abnahme der Inzidenz chronischer Niereninsuffizienz nahe.
Schlüsselwörter
Prävalenz - Inzidenz - Methodik
Key words
prevalence - incidence - methodology
