Clinical and Experimental Nephrology

, 15:708

Geographic differences in the increasing ESRD rate have disappeared in Japan

  • Tamaki Wakamatsu-Yamanaka
  • Michio Fukuda
  • Ryo Sato
  • Takehiro Naito
  • Hiroyuki Togawa
  • Tatsuya Tomonari
  • Yoko Kato
  • Toshiyuki Miura
  • Masashi Mizuno
  • Tadashi Ichikawa
  • Sota Miyagi
  • Yuichi Shirasawa
  • Akinori Ito
  • Atsuhiro Yoshida
  • Genjiro Kimura
Original Article

DOI: 10.1007/s10157-011-0466-5

Cite this article as:
Wakamatsu-Yamanaka, T., Fukuda, M., Sato, R. et al. Clin Exp Nephrol (2011) 15: 708. doi:10.1007/s10157-011-0466-5

Abstract

Background

We previously showed that there are marked geographic differences in the incidence of end-stage renal disease (ESRD) within Japan. In addition, the use of renin–angiotensin system inhibitors was found to be inversely correlated with the increasing ESRD rate. It was recently demonstrated that the incidence of ESRD due to diabetic nephropathy is declining in both Europe and USA. Therefore, we investigated the increasing ESRD rate and its geographic difference in Japan.

Methods

Each year, the Japanese Society for Dialysis Therapy reports the numbers of patients initiating maintenance dialysis therapy in each prefecture of Japan. We used old (1984–1991) and recent (2001–2008) data to compare the increasing ESRD rate, which was estimated from the slope of the regression line of the annual incidence corrected for population, between the two periods in 11 regions of Japan.

Results

Increasing ESRD rate almost halved, from 11.1 ± 5.6 to 5.4 ± 0.7/million per year from the old to the recent period. Deceleration of the increasing ESRD rate from the old to the recent period was correlated with the incidence in the old period across 11 regions (r = 0.81, p < 0.003); i.e., the deceleration was greater in the regions where ESRD incidence had been higher. Whereas the increasing ESRD rate was significantly different among regions in the old period, this was not the case in the recent period, resulting in uniformity throughout Japan.

Conclusions

The increasing ESRD rate is slowing in Japan, and its geographic differences, previously observed, have disappeared.

Keywords

End-stage renal diseaseGeographic differenceIncidencePreventionProgression

Copyright information

© Japanese Society of Nephrology 2011

Authors and Affiliations

  • Tamaki Wakamatsu-Yamanaka
    • 1
  • Michio Fukuda
    • 1
  • Ryo Sato
    • 1
  • Takehiro Naito
    • 1
  • Hiroyuki Togawa
    • 1
  • Tatsuya Tomonari
    • 1
  • Yoko Kato
    • 1
  • Toshiyuki Miura
    • 1
  • Masashi Mizuno
    • 1
  • Tadashi Ichikawa
    • 1
  • Sota Miyagi
    • 1
  • Yuichi Shirasawa
    • 1
  • Akinori Ito
    • 1
  • Atsuhiro Yoshida
    • 1
  • Genjiro Kimura
    • 1
  1. 1.Department of Cardio-Renal Medicine and HypertensionNagoya City University Graduate School of Medical SciencesNagoyaJapan