目的 分析1990-2019年中国慢性肾病的发病时间趋势,评估年龄、时期和队列效应,并预测2020-2034年中国慢性肾病的发病情况,为慢性肾病相关防治政策和措施提供参考依据.方法 利用2019全球疾病负担研究(Global Burden of Disease Study 2019,GBD 2019)数据,应用Joinpoint回归模型分析不同性别慢性肾病发病趋势变化并计算年度变化百分比(annual percentage change,APC)与平均年度变化百分 比(average annual percentage change,AAPC);借助年龄-时期-队列模型分析年龄、时期及队列因素对不同性别慢性肾病发病率的影响;采用贝叶斯年龄-时期-队列分析方法预测2020-2034年不同性别慢性肾病的发病率和发病人数.结果 1990-2019年中国全人群和男、女性慢性肾病标准化发病率总体均呈上升趋势(AAPC=0.30％、0.30％、0.29％,均 P＜0.001),女性在 1993-1996 年(APC=-0.54％,P=0.073)无规律变化,女性较男性有更高的发病率,但近年男性发病率增长速度远高于女性.中国慢性肾病发病率变化受年龄、时期、队列因素影响(均P＜0.001),慢性肾病发病风险总体上随年龄增加而增加,在60岁之后明显上升;在1995年之后随时期持续上升;在2005年之前随出生队列上升,在2005年之后随出生队列下降.2020-2034年中国慢性肾病标化发病率和发病人数预计呈上升趋势,且男性增长幅度高于女性.结论 1990-2019年中国慢性肾病发病率和发病人数总体不断升高.建议加强对老年人以及高血压和糖尿病患者等高危人群的防护和婴幼儿的营养摄入和健康检查.
Study on the trend and forecast of the incidence of chronic kidney disease in China from 1990 to 2019
Objective To analyze the incidence time trend of chronic kidney disease(CKD)in China from 1990 to 2019,evaluate its age,period and cohort effect,and predict the incidence of chronic kidney disease in China from 2020 to 2034,so as to provide reference for relevant prevention and treat-ment policies and measures of CKD.Methods Based on the data of the Global Burden of Disease Study 2019(GBD 2019),the Joinpoint regression model was used to analyze the trend change of chronic kidney disease in different genders,and the annual percentage change(APC)and the average annual percentage change(AAPC)were calculated.With the help of age-period-cohort model,the influence of age,period and cohort factors on the incidence of CKD in different sexes was analyzed.Bayesian age-period-cohort analysis was used to predict the incidence and number of CKD in different gender from 2020 to 2034.Results From 1990 to 2019,the standardized incidence rate of CKD in the entire population,as well as among men and women in China,demonstrated an overall upward trajectory(AAPC=0.30％,0.30％,0.29％,all P＜0.001).Notably,there was an irregular variation observed in women during the years 1993-1996(APC=-0.54％,P=0.073),with females exhibiting a higher incidence rate than males.However,the incidence rate in males has escalated at a significantly higher pace than that in females in recent years.The fluctuations in chronic kidney disease incidence in China were influenced by age,period,and cohort factors(all P＜0.001).The overall risk of CKD increased with age,experiencing a notable rise after the age of 60.Furthermore,the incidence continued to rise post-1995,associated with birth cohorts before 2005,and demonstrated a decline after 2005.Projections for the period from 2020 to 2034 anticipate an upward trend in the standardized incidence rate and the number of cases of chronic kidney disease in China,with a more pronounced increase among males compared to females.Conclusions From 1990 to 2019,the incidence rate and the number of cases of CKD in China demonstrated a continuous upward trend.It is advisable to bolster preventive measures for the elderly and high-risk populations,particularly individuals with hypertension and diabetes.Moreover,careful consideration should be given to the nutritional intake and health assessments of infants and young children.
NETL
NSTL
万方数据
