Objective To understand the prevalence of chronic kidney disease (CKD) among rural residents of north central areas of Zhejiang,and to analyze the related risk factors.Methods A total of 1 654 native residents aged ≥18years and living at least 5 years in the areas were selected from four villages in north-central areas of Zhejiang.All participants completed the questionnaire about the risk factors related to CKD and received physical examination as well as urine and blood test.The standardized prevalence of CKD was calculated based on the distribution of age and gender in the sixth census data in rural areas of Zhejiang.Risk factors related to CKD were analyzed by univariate analysis and multivariable logistic regression analysis.Results After adjusting the age and gender,the overall prevalence of CKD was 9.44％ (95％ CI:8.03-10.85),the prevalence of albuminuria and reduced renal function were 8.02％ (95％CI:6.71-9.33) and 2.65％ (95％CI:1.88-3.42).The awareness rate for CKD was 6.49％.Gender,age,BMI,SBP,FBG (fasting blood-glucose),blood uric acid were found to be independent risk factors of CKD,while DBP,cholesterol,HDL-C,LDL-C and triglyceride were factors unrelated to CKD.Conclusions The prevalence of CKD of rural residents in north-central areas of Zhejiang shows a up-ward trend along with age and the increase of BMI,SBP,FBG and blood uric acid.The prevalence of female residents is significantly higher than male individuals.

Introduction: The objective of this study was to systematically review the literature and perform a meta-analysis comparing the clinical outcomes of telehealth and usual care in the management of diabetes. Methods: Multiple strategies, including database searches (MEDLINE, PsycINFO, PubMed, EMBASE, and CINAHL), searches of related journals and reference tracking, were employed to widely search publications from January 2005 to December 2017. The change in hemoglobin A1c (HbA1c) levels was assessed as the primary outcome, and changes in blood pressure, blood lipids, body mass index (BMI), and quality of life were examined as secondary outcomes. Results: Nineteen randomized controlled trials (n=6294 participants) were selected. Telehealth was more effective than usual care in controlling the glycemic index in diabetes patients (weighted mean difference = -0.22%; 95% confidence intervals, -0.28 to -0.15; P < .001). This intervention showed promise in reducing systolic blood pressure levels (P < .001) and diastolic blood pressure levels (P < .001), while no benefits were observed in the control of BMI (P = .79). For total cholesterol and quality of life, telehealth was similar or superior to usual care. Conclusion: Telehealth holds promise for improving the clinical effectiveness of diabetes management. Targeting patients with higher HbA1c (>= 9%) levels and delivering more frequent intervention (at least 6 times 1 year) may achieve greater improvement.