Abstract
Background
The number of patients with end-stage renal disease (ESRD) in Japan has continuously increased in the past three decades. In 2005, 36 063 patients whose average age was 66 years entered a new dialysis program. This large number of ESRD patients could be just the tip of the iceberg of an increasing number of patients with chronic kidney disease (CKD). However, to date, a nationwide epidemiological study has not been conducted yet to survey the CKD population.
Methods
Data for 527 594 (male, 211 034; female, 316 560) participants were obtained from the general adult population aged over 20 years who received annual health check programs in 2000–2004, from seven different prefectures in Japan: Hokkaido, Fukushima, Ibaraki, Tokyo, Osaka, Fukuoka, and Okinawa prefectures. The glomerular filtration rate (GFR) for each participant was estimated from the serum creatinine values, using the abbreviated Modification of Diet in Renal Disease (MDRD) study equation modified by the Japanese coefficient.
Results
The prevalences of CKD stage 3 in the study population, stratified by age groups of 20–29, 30–39, 40–49, 50–59, 60–69, 70–79, and 80–89 years, were 1.4%, 3.6%, 10.8%, 15.9%, 31.8%, 44.0%, and 59.1%, respectively, predicting 19.1 million patients with stage 3 CKD in the Japanese general adult population of 103.2 million in 2004. CKD stage 4 + 5 was predicted in 200 000 patients in the Japanese general adult population. Comorbidity of hypertension, diabetes, and proteinuria increased as the estimated GFR (eGFR) decreased. The prevalence of concurrent CKD was significantly higher in hypertensive and diabetic populations than in the study population overall when CKD was defined as being present with an eGFR of less than 40 ml/min per 1.73 m2 instead of less than 60 ml/min per 1.73 m2.
Conclusions
About 20% of the Japanese adult population (i.e., approximately 19 million people) are predicted to have stage 3 to 5 CKD, as defined by a GFR of less than 60 ml/min per 1.73 m2.
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References
L Wesson (1969) Renal hemodynamics in physiologic state L Wesson (Eds) Physiology of human kidney Grune and Stratton New York 96–108
InstitutionalAuthorNameNational-Kidney Foundation (2002) ArticleTitleK/DOQI Clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification Am J Kidney Dis 39 S1–S266
A Levey K Eckardt Y Tsukamoto A Levin J Coresh J Rossert et al. (2005) ArticleTitleDefinition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO) Kidney Int 67 2089–100 Occurrence Handle10.1111/j.1523-1755.2005.00365.x Occurrence Handle15882252
J Coresh B Astor T Greene G Eknoyan A Levey (2003) ArticleTitlePrevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey Am J Kidney Dis 41 1–12 Occurrence Handle10.1053/ajkd.2003.50007 Occurrence Handle12500213
Y Ma L Zuo J Chen Q Luo X Yu Y Li et al. (2006) ArticleTitleModified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease J Am Soc Nephrol 17 2937–44 Occurrence Handle10.1681/ASN.2006040368 Occurrence Handle16988059
E Imai M Horio K Nitta K Yamagata K Iseki S Hara et al. (2007) ArticleTitleEstimation of glomerular filtration rate by the MDRD equation modified for Japanese patients with chronic kidney disease Clin Exp Nephrol 11 41–50 Occurrence Handle10.1007/s10157-006-0453-4 Occurrence Handle17384997
J Coresh D Byrd-Holt B Astor J Briggs P Eggers D Lacher T Hostetter (2005) ArticleTitleChronic kidney disease awareness, prevalence, and trends among US adults, 1999 to 2000 J Am Soc Nephrol 16 180–8 Occurrence Handle10.1681/ASN.2004070539 Occurrence Handle15563563
S Hallan J Coresh B Astor A Asberg N Powe S Romundstad et al. (2006) ArticleTitleInternational comparison of the relationship of chronic kidney disease prevalence and ESRD risk J Am Soc Nephrol 17 2275–84 Occurrence Handle10.1681/ASN.2005121273 Occurrence Handle16790511
A Go G Chertow D Fan C MuCulloch C Hsu (2004) ArticleTitleChronic kidney disease and risks of death, cardiovascular events, and hospitalization N Engl J Med 351 1296–305 Occurrence Handle1:CAS:528:DC%2BD2cXnvFSgtr8%3D Occurrence Handle10.1056/NEJMoa041031 Occurrence Handle15385656
J Chen R Wildman D Gu J Kusek M Spruill K Reynolds et al. (2005) ArticleTitlePrevalence of decreased kidney function in Chinese adults aged 35 to 75 years Kidney Int 68 2837–45 Occurrence Handle10.1111/j.1523-1755.2005.00757.x Occurrence Handle16316361
L Zuo Y Ma Y Zhou M Wang G Xu H Wang (2005) ArticleTitleApplication of GFR-estimating equations in Chinese patients with chronic kidney disease Am J KIdney Dis 45 463–72 Occurrence Handle10.1053/j.ajkd.2004.11.012 Occurrence Handle15754268
C Meisinger A Doering H Loewel (2006) ArticleTitleChronic kidney disease and risk of incident myocardial infarction and all-cause and cardiovascular disease mortality in middle-aged men and women from the general population Eur Heart J 27 1245–50 Occurrence Handle10.1093/eurheartj/ehi880 Occurrence Handle16611670
T Jafar (2006) ArticleTitleHypertension and kidney disease in Asia Curr Opin Nephrol Hypertens 15 291–5 Occurrence Handle10.1097/01.mnh.0000222697.30207.4e Occurrence Handle16609297
Y Orita M Okada S Harada M Horio (2004) ArticleTitleSkim soy protein enhances GFR as much as beefsteak protein in healthy human subjects Clin Exp Nephrol 8 103–8 Occurrence Handle1:CAS:528:DC%2BD2cXlvFSgur4%3D Occurrence Handle10.1007/s10157-004-0277-z Occurrence Handle15235926
S Barai G Bandopadhayaya C Patel M Rathi B Kumar D Bhowmik et al. (2005) ArticleTitleDo healthy potential kidney donors in India have an average glomerular filtration rate of 81.4 ml/min? Nephron Physiol 101 21–6 Occurrence Handle10.1159/000086038
D Davis N Shock (1950) ArticleTitleAge changes in glomerular filtration rate, effective renal plasma flow, and tubular excretion capacity in adult males J Clin Invest 29 496–507 Occurrence Handle10.1172/JCI102286
K Iseki Y Ikeyama C Iseki S Takishita (2003) ArticleTitleProteinuria and the risk of developing end-stage renal disease Kidney Int 63 1468–74 Occurrence Handle10.1046/j.1523-1755.2003.00868.x Occurrence Handle12631363
K Iseki K Kinjo C Iseki S Takishita (2004) ArticleTitleRelationship between predicted creatinine clearance and proteinuna and the risk of developing FSRD in Okinawa, Japan Am J Kidney Dis 44 806–14 Occurrence Handle1:CAS:528:DC%2BD2cXhtVahtLrE Occurrence Handle10.1016/S0272-6386(04)01080-7 Occurrence Handle15492946
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This work was presented in part at the 48th annual meeting of the Japanese Society of Nephrology at Yokohama in 2005.
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Imai, E., Horio, M., Iseki, K. et al. Prevalence of chronic kidney disease (CKD) in the Japanese general population predicted by the MDRD equation modified by a Japanese coefficient. Clin Exp Nephrol 11, 156–163 (2007). https://doi.org/10.1007/s10157-007-0463-x
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DOI: https://doi.org/10.1007/s10157-007-0463-x