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

  • Enyu Imai
  • Masaru Horio
  • Kunitoshi Iseki
  • Kunihiro Yamagata
  • Tsuyoshi Watanabe
  • Shigeko Hara
  • Nobuyuki Ura
  • Yutaka Kiyohara
  • Hideki Hirakata
  • Toshiki Moriyama
  • Yasuhiro Ando
  • Kosaku Nitta
  • Daijo Inaguma
  • Ichiei Narita
  • Hiroyasu Iso
  • Kenji Wakai
  • Yoshinari Yasuda
  • Yusuke Tsukamoto
  • Sadayoshi Ito
  • Hirofumi Makino
  • Akira Hishida
  • Seiichi Matsuo
ORIGINAL 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.

Key words

CKD Hypertension Proteinuria Diabetes MDRD equation 

Copyright information

© Japanese Society of Nephrology 2007

Authors and Affiliations

  • Enyu Imai
    • 1
  • Masaru Horio
    • 2
  • Kunitoshi Iseki
    • 3
  • Kunihiro Yamagata
    • 4
  • Tsuyoshi Watanabe
    • 5
  • Shigeko Hara
    • 6
  • Nobuyuki Ura
    • 7
  • Yutaka Kiyohara
    • 8
  • Hideki Hirakata
    • 9
  • Toshiki Moriyama
    • 10
  • Yasuhiro Ando
    • 11
  • Kosaku Nitta
    • 12
  • Daijo Inaguma
    • 13
  • Ichiei Narita
    • 14
  • Hiroyasu Iso
    • 15
  • Kenji Wakai
    • 16
  • Yoshinari Yasuda
    • 17
  • Yusuke Tsukamoto
    • 18
  • Sadayoshi Ito
    • 19
  • Hirofumi Makino
    • 20
  • Akira Hishida
    • 21
  • Seiichi Matsuo
    • 17
  1. 1.Department of NephrologyOsaka University Graduate School of MedicineOsakaJapan
  2. 2.Department of Functional Diagnostic ScienceOsaka University Graduate School of MedicineOsakaJapan
  3. 3.Dialysis UnitUniversity Hospital of The RyukyusOkinawaJapan
  4. 4.Department of NephrologyInstitute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of TsukubaIbarakiJapan
  5. 5.Third Department of MedicineFukushima Medical UniversityFukushimaJapan
  6. 6.Health Medical CenterToranomon HospitalTokyoJapan
  7. 7.Second Department of Internal MedicineSapporo Medical University School of MedicineSapporoJapan
  8. 8.Department of Environmental MedicineGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
  9. 9.Nephrology and Dialysis CenterFukuoka Red Cross HospitalFukuokaJapan
  10. 10.Healthcare CenterOsaka UniversityOsakaJapan
  11. 11.Department of NephrologyJichi Medical SchoolTochigiJapan
  12. 12.Department of Medicine, Kidney CenterTokyo Women's Medical UniversityTokyoJapan
  13. 13.Tosei General HospitalAichiJapan
  14. 14.Division of Nephrology and RheumatologyNiigata UniversityNiigataJapan
  15. 15.Department of Public HealthOsaka University Graduate School of MedicineOsakaJapan
  16. 16.Aichi Cancer InstituteJapan
  17. 17.Department of NephrologyNagoya University Graduate School of MedicineNagoyaJapan
  18. 18.Syuwa General HospitalJapan
  19. 19.Division of NephrologyEndocrinology and Vascular Medicine, Tohoku University Graduate School of MedicineMiyagiJapan
  20. 20.Department of Medicine and Clinical ScienceOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
  21. 21.First Department of MedicineHamamatsu University School of MedicineShizuokaJapan

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