单位:[1]Department of Medicine and Therapeutics, The Chinese University of Hong Kong[2]Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong SAR[3]Department of Endocrinology, Peking University First Hospital, Beijing[4]Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai[5]Peking Union Medical College Hospital, Beijing[6]The Third Affiliated Hospital of Sun Yat-Sen University, Guangdong中山大学附属第三医院[7]Department of Endocrinology, China–Japan Friendship Hospital, Beijing[8]Qualigenics Diabetes Centre[9]Alice Ho Nethersole Hospital, Hong Kong SAR, China[10]Dr M.K. Mukhopadhyay’s Diabetic Clinic, Kolkata[11]ILS Hospital, Salt Lake, India[12]Hallym University College of Medicine, Gangwon-do[13]The Catholic University of Korea, Seocho-gu, Korea[14]Heart of Jesus Hospital, San Jose City[15]Senor Sto. Nino Hospital, Tarlac[16]New Bilibid Prison Hospital, Bureau of Corrections, Muntinlupa, Philippines[17]Taichung Veterans General Hospital, Taichung, Taiwan[18]Bach Mai Hospital, Hanoi[19]HCMC University of Pharmaceutical and Medicine, Ho Chi Minh City, Vietnam[20]Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong SAR, China
AimsDiabetic kidney disease independently predicts cardiovascular disease and premature death. We examined the burden of chronic kidney disease (CKD, defined as an estimated GFR < 60 ml/min/1.73 m(2)) and quality of care in a cross-sectional survey of adults (age 18 years) with Type 2 diabetes across Asia. MethodsThe Joint Asia Diabetes Evaluation programme is a disease-management programme implemented using an electronic portal that systematically captures clinical characteristics of all patients enrolled. Between July 2007 and December 2012, data on 28 110 consecutively enrolled patients (China: 3415, Hong Kong: 15 196, India: 3714, Korea: 1651, Philippines: 3364, Vietnam: 692, Taiwan: 78) were analysed. ResultsIn this survey, 15.9% of patients had CKD, 25.0% had microalbuminuria and 12.5% had macroalbuminuria. Patients with CKD were less likely to achieve HbA(1c) < 53 mmol/mol (7.0%) (36.0% s. 42.3%) and blood pressure < 130/80 mmHg (20.8% vs. 35.3%), and were more likely to have retinopathy (26.2% vs. 8.7%), sensory neuropathy (29.0% vs. 7.7%), cardiovascular disease (26.6% vs. 8.7%) and self-reported hypoglycaemia (18.9% vs. 8.2%). Despite high frequencies of albuminuria (74.8%) and dyslipidaemia (93.0%) among CKD patients, only 49.0% were using renin-angiotensin system inhibitors and 53.6% were on statins. On logistic regression, old age, male gender, tobacco use, long disease duration, high HbA(1c), blood pressure and BMI, and low LDL cholesterol were independently associated with CKD (all P < 0.05). ConclusionsThe poor control of risk factors, suboptimal use of organ-protective drugs and high frequencies of hypoglycaemia highlight major treatment gaps in patients with diabetic kidney disease in Asia.
第一作者单位:[1]Department of Medicine and Therapeutics, The Chinese University of Hong Kong
通讯作者:
推荐引用方式(GB/T 7714):
Luk A. O.,Li X.,Zhang Y.,et al.Quality of care in patients with diabetic kidney disease in Asia: The Joint Asia Diabetes Evaluation (JADE) Registry[J].DIABETIC MEDICINE.2016,33(9):1230-1239.doi:10.1111/dme.13014.
APA:
Luk, A. O.,Li, X.,Zhang, Y.,Guo, X.,Jia, W....&Chan, J. C..(2016).Quality of care in patients with diabetic kidney disease in Asia: The Joint Asia Diabetes Evaluation (JADE) Registry.DIABETIC MEDICINE,33,(9)
MLA:
Luk, A. O.,et al."Quality of care in patients with diabetic kidney disease in Asia: The Joint Asia Diabetes Evaluation (JADE) Registry".DIABETIC MEDICINE 33..9(2016):1230-1239