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Birth cohort effects in incident renal replacement therapy in Japan, 1982–2021

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Abstract

Background

This study aimed to investigate the long-term trends of incident end-stage kidney disease (ESKD) requiring renal replacement therapy (RRT) in Japan using age-period-cohort analysis and evaluated birth cohort effects for incident ESKD requiring RRT.

Methods

The number of incident RRT patients aged between 20 and 84 years by sex from 1982 to 2021 was extracted from the Japanese Society of Dialysis Therapy registry data. Annual incidence rates of RRT were calculated using census population as denominators, and changes in the incidence rates were evaluated using an age-period-cohort model. The age and survey year period categories generated 20 birth cohorts with 5-year intervals (from 1902–1907 to 1997–2001).

Results

The incidence rates of RRT in both sexes initially rose in the birth cohorts born in the early 1900s, and then decelerated and peaked during 1940–1960s in men and 1930–1940s in women, following a steady decline in both sexes. Compared with the reference 1947–1951 birth cohort, the highest cohort rate ratio was 1.14 (95% CI, 1.04–1.25) in the 1967–1971 birth cohort in men and 1.04 (95% CI, 0.98–1.10) in the 1937–1941 birth cohort in women.

Conclusions

Significant cohort effects were identified in both sexes, but the peak of RRT was different for each sex. Our findings suggest that men born between 1940 and 1960s and women born between 1930 and 40 s may be important target populations to consider when decreasing incidence rates of RRT among the general Japanese population.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author (MW) on reasonable request.

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Acknowledgements

This work was supported by a research grant from JSPS KAKENHI (Grant-in-Aid for Scientific Research, Grant Number JP18K08202) and a grant-in-aid for the contributions to the promotion of measures against chronic kidney disease (CKD) based on the Kidney Disease Control Commission Meeting report, Health, Labour and Welfare Sciences Research Grants (Research on Renal Diseases) from the Ministry of Health, Labour and Welfare, Japan (Grant Number 22FD01001). No funding agencies played any role in the study design, collection, analysis, and interpretation of the data, writing the report, and the decision to submit the report for publication.

We thank the Committee of the Renal Data Registry of the Japanese Society for Dialysis Therapy (JSDT) for permission to use their registry data. The results of the current study were derived from split data from the WADDA system of the JSDT by the authors. However, the interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the JSDT.

Funding

This work was supported by a research grant from JSPS KAKENHI (Grant-in-Aid for Scientific Research, Grant Number JP18K08202) and a grant-in-aid for the contributions to the promotion of measures against chronic kidney disease (CKD) based on the Kidney Disease Control Commission Meeting report, Health, Labour and Welfare Sciences Research Grants (Research on Renal Diseases) from the Ministry of Health, Labour and Welfare, Japan (Grant Number 22FD01001). No funding agencies played any role in the study design, collection, analysis, and interpretation of the data, writing the report, and the decision to submit the report for publication. The authors declare that they have no other relevant financial interests.

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Authors and Affiliations

  1. Department of Inter-Organ Communication Research, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi, Chuo-Ku, Niigata, 951-8510, Japan

    Minako Wakasugi

  2. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Ichiei Narita

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  1. Minako Wakasugi
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Correspondence to Minako Wakasugi.

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Wakasugi, M., Narita, I. Birth cohort effects in incident renal replacement therapy in Japan, 1982–2021. Clin Exp Nephrol 27, 707–714 (2023). https://doi.org/10.1007/s10157-023-02345-x

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