title: Prevalence of chronic kidney disease in China: a cross-sectional survey.
abstract: BACKGROUND
  The prevalence of chronic kidney disease is high in developing countries. However, no national survey of chronic kidney disease has been done incorporating both estimated glomerular filtration rate (eGFR) and albuminuria in a developing country with the economic diversity of China. We aimed to measure the prevalence of chronic kidney disease in China with such a survey.
  
  
  METHODS
  We did a cross-sectional survey of a nationally representative sample of Chinese adults. Chronic kidney disease was defined as eGFR less than 60 mL/min per 1·73 m(2) or the presence of albuminuria. Participants completed a lifestyle and medical history questionnaire and had their blood pressure measured, and blood and urine samples taken. Serum creatinine was measured and used to estimate glomerular filtration rate. Urinary albumin and creatinine were tested to assess albuminuria. The crude and adjusted prevalence of indicators of kidney damage were calculated and factors associated with the presence of chronic kidney disease analysed by logistic regression.
  
  
  RESULTS
  50,550 people were invited to participate, of whom 47,204 agreed. The adjusted prevalence of eGFR less than 60 mL/min per 1·73 m(2) was 1·7% (95% CI 1·5-1·9) and of albuminuria was 9·4% (8·9-10·0). The overall prevalence of chronic kidney disease was 10·8% (10·2-11·3); therefore the number of patients with chronic kidney disease in China is estimated to be about 119·5 million (112·9-125·0 million). In rural areas, economic development was independently associated with the presence of albuminuria. The prevalence of chronic kidney disease was high in north (16·9% [15·1-18·7]) and southwest (18·3% [16·4-20·4]) regions compared with other regions. Other factors independently associated with kidney damage were age, sex, hypertension, diabetes, history of cardiovascular disease, hyperuricaemia, area of residence, and economic status.
  
  
  CONCLUSIONS
  Chronic kidney disease has become an important public health problem in China. Special attention should be paid to residents in economically improving rural areas and specific geographical regions in China.
  
  
  BACKGROUND
  The Ministry of Science and Technology (China); the Science and Technology Commission of Shanghai; the National Natural Science Foundation of China; the Department of Health, Jiangsu Province; the Sichuan Science and Technology Department; the Ministry of Education (China); the International Society of Nephrology Research Committee; and the China Health and Medical Development Foundation.
authors.affiliation: Peking University Institute of Nephrology, Division of Nephrology, Peking University First Hospital, Beijing, China.
authors.forename: Luxia
authors.initials: L
authors.lastname: Zhang
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Wenke
authors.initials: W
authors.lastname: Wang
authors.forename: Bicheng
authors.initials: B
authors.lastname: Liu
authors.forename: Jian
authors.initials: J
authors.lastname: Liu
authors.forename: Menghua
authors.initials: M
authors.lastname: Chen
authors.forename: Qiang
authors.initials: Q
authors.lastname: He
authors.forename: Yunhua
authors.initials: Y
authors.lastname: Liao
authors.forename: Xueqing
authors.initials: X
authors.lastname: Yu
authors.forename: Nan
authors.initials: N
authors.lastname: Chen
authors.forename: Jian-e
authors.initials: JE
authors.lastname: Zhang
authors.forename: Zhao
authors.initials: Z
authors.lastname: Hu
authors.forename: Fuyou
authors.initials: F
authors.lastname: Liu
authors.forename: Daqing
authors.initials: D
authors.lastname: Hong
authors.forename: Lijie
authors.initials: L
authors.lastname: Ma
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Zhou
authors.forename: Jianghua
authors.initials: J
authors.lastname: Chen
authors.forename: Ling
authors.initials: L
authors.lastname: Pan
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Weiming
authors.initials: W
authors.lastname: Wang
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Li
authors.forename: Haiyan
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000209:etiology; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D011795:Surveys and Questionnaires