, Volume 2, Issue 1, pp 31-37

Outcome of subjects with elevated serum creatinine in a community-based mass screening

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Abstract

Background

The outcome and prognosis of screened subjects with elevated levels of serum creatinine (>-176.8 μmol/L [≥2.0 mg/dL]) in a community-based mass health screening were examined in Okinawa, Japan.

Methods

From 1983 to 1992, a total of more than 1.24 million people had received at least 1 screening by the Okinawa General Health Maintenance Association. The status of 250,091 individuals for whom data on serum creatine levels was available, as of January 1, 1996, was examined by using information from the Okinawa Dialysis Study registry, which included data on the end-stage renal disease (ESRD) program, and by reviewing the medical charts.

Results

A total of 289 screened subjects (187 men and 102 women) were investigated in this study. The total duration of observation was 1081.8 person-years. Clinical demographics and the incidence of ESRD, and the death of patients with ESRD before starting dialysis therapy (ESRD+death) were compared in 2 consecutive periods: A (1983 to 1987) and B (1988 to 1992). The incidence of ESRD and ESRD+death was 122.4 (161.5) per 1000 person-years in period A, whereas that of period B was 143.8 (170.2) per 1000 person-years. In the period 1988 to 1992, the hazards ratio for ESRD and ESRD+death was 1.50 and 1.38, respectively. The 95% confidence interval was 1.05 to 2.15 and 0.99 to 1.91, respectively, when compared to the period of 1983 to 1987.

Conclusion

This study shows that the risk of ESRD and ESRD+death is not decreasing, therefore the current strategy for the prevention of ESRD is not satistactory. Further study is needed to determine the underlying causes and mechanisms of the progression of renal disease.