Prevalence of chronic kidney disease (CKD) in the Japanese general population predicted by the MDRD equation modified by a Japanese coefficient

Clinical and Experimental Nephrology volume 11, pages156–163(2007)Cite this article

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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Affiliations

  1. Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan

    Enyu Imai

  2. Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Osaka, Japan

    Masaru Horio

  3. Dialysis Unit, University Hospital of The Ryukyus, Okinawa, Japan

    Kunitoshi Iseki

  4. Department of Nephrology, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan

    Kunihiro Yamagata

  5. Third Department of Medicine, Fukushima Medical University, Fukushima, Japan

    Tsuyoshi Watanabe

  6. Health Medical Center, Toranomon Hospital, Tokyo, Japan

    Shigeko Hara

  7. Second Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan

    Nobuyuki Ura

  8. Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yutaka Kiyohara

  9. Nephrology and Dialysis Center, Fukuoka Red Cross Hospital, Fukuoka, Japan

    Hideki Hirakata

  10. Healthcare Center, Osaka University, Osaka, Japan

    Toshiki Moriyama

  11. Department of Nephrology, Jichi Medical School, Tochigi, Japan

    Yasuhiro Ando

  12. Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan

    Kosaku Nitta

  13. Tosei General Hospital, Aichi, Japan

    Daijo Inaguma

  14. Division of Nephrology and Rheumatology, Niigata University, Niigata, Japan

    Ichiei Narita

  15. Department of Public Health, Osaka University Graduate School of Medicine, Osaka, Japan

    Hiroyasu Iso

  16. Aichi Cancer Institute, Japan

    Kenji Wakai

  17. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshinari Yasuda & Seiichi Matsuo

  18. Syuwa General Hospital, Japan

    Yusuke Tsukamoto

  19. Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan

    Sadayoshi Ito

  20. Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

    Hirofumi Makino

  21. First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan

    Akira Hishida

Authors
  1. Enyu Imai
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  2. Masaru Horio
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  3. Kunitoshi Iseki
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  4. Kunihiro Yamagata
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  5. Tsuyoshi Watanabe
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  6. Shigeko Hara
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  7. Nobuyuki Ura
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  8. Yutaka Kiyohara
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  9. Hideki Hirakata
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  10. Toshiki Moriyama
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  11. Yasuhiro Ando
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  12. Kosaku Nitta
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  13. Daijo Inaguma
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  14. Ichiei Narita
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  15. Hiroyasu Iso
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  16. Kenji Wakai
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  17. Yoshinari Yasuda
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  18. Yusuke Tsukamoto
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  19. Sadayoshi Ito
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  20. Hirofumi Makino
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  21. Akira Hishida
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  22. Seiichi Matsuo
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Corresponding author

Correspondence to Enyu Imai.

Additional information

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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Cite this article

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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Key words

  • CKD
  • Hypertension
  • Proteinuria
  • Diabetes
  • MDRD equation