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DOI: 10.1055/s-0043-113464
Epidemiologie chronischer Nierenerkrankungen – werden es immer mehr Patienten?
Epidemiology of Chronic Kidney Disease – Ever More Patients?Publication History
Publication Date:
29 August 2017 (online)
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.
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Literatur
- 1 Störk S, Wanner C. Kardiorenales Syndrom. Aktuelle Kardiologie 2016; 5: 191-197
- 2 Neuhauser H, Diederichs C, Boeing H. et al. Bluthochdruck in Deutschland. Dtsch Ärztebl Int 2016; 113: 809-815
- 3 Finger JD, Busch MA, Du Y. et al. Time Trends in Cardiometabolic Risk Factors in Adults. Dtsch Ärztebl Int 2016; 113: 712-719
- 4 Centers for Disease Control and Prevention. CDC – Diagnosed Diabetes – Data & Trends – Diabetes DDT. Im Internet: http://www.cdc.gov/diabetes/statistics/prevalence_national.htm Stand: 17.02.2017
- 5 Pippias M, Jager KJ, Kramer A. et al. The changing trends and outcomes in renal replacement therapy: data from the ERA-EDTA Registry. Nephrol Dial Transplant 2016; 31: 831-841
- 6 Glassock RJ, Warnock DG, Delanaye P. The global burden of chronic kidney disease: estimates, variability and pitfalls. Nat Rev Nephrol 2017; 13: 104-114
- 7 Ebert N, Jakob O, Gaedeke J. et al. Prevalence of reduced kidney function and albuminuria in older adults: the Berlin Initiative Study. Nephrol Dial Transplant 2017; 32: 997-1005
- 8 Glassock RJ, Rule AD. Aging and the Kidneys: Anatomy, Physiology and Consequences for Defining Chronic Kidney Disease. Nephron 2016; 134: 25-29
- 9 Schneider MP, Hübner S, Titze SI. et al. Implementation of the KDIGO guideline on lipid management requires a substantial increase in statin prescription rates. Kidney Int 2015; 88: 1411-1418
- 10 Li PKT, Chow KM, Van de Luijtgaarden MWM. et al. Changes in the worldwide epidemiology of peritoneal dialysis. Nat Rev Nephrol 2017; 13: 90-103
- 11 Bundesministerium des Innern. Jedes Alter zählt “Für mehr Wohlstand und Lebensqualität aller Generationen“. Im Internet: http://www.bmi.bund.de/SharedDocs/Downloads/DE/Broschueren/2017/demografiebilanz.html Stand: 18.02.2017
- 12 GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388: 1545-1602
- 13 Liyanage T, Ninomiya T, Jha V. et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet 2015; 385: 1975-1982
- 14 Nephrologen fordern Aufbau eines Dialyseregisters. Deutsches Ärzteblatt. Im Internet: https://www.aerzteblatt.de/nachrichten/70461 Stand:
- 15 Collins AJ, Foley RN, Chavers B. et al. US Renal Data System 2013 Annual Data Report. Am J Kidney Dis Off J Natl Kidney Found 2014; 63: A7
- 16 Brück K, Stel VS, Gambaro G. et al. CKD Prevalence Varies across the European General Population. J Am Soc Nephrol 2016; 27: 2135-2147
- 17 NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. Lancet Lond Engl 2017; 389: 37-55
- 18 Tamayo T, Brinks R, Hoyer A. et al. The Prevalence and Incidence of Diabetes in Germany. Dtsch Ärztebl Int 2016; 113: 177-182
- 19 Zimmet P, Alberti KG, Magliano DJ. et al. Diabetes mellitus statistics on prevalence and mortality: facts and fallacies. Nat Rev Endocrinol 2016; 12: 616-622
- 20 Wanner C, Ketteler M. Chronisches Nierenversagen. Dtsch Med Wochenschr 2017; 142: 193-196
- 21 Wanner C, Inzucchi SE, Lachin JM. et al. Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. N Engl J Med 2016; 375: 323-334
- 22 ERA-EDTA. ERA-EDTA Registry: contributors. Im Internet: https://www.era-edta-reg.org/index.jsp?p=10 Stand: 19.02.2017