Skip to main content

Advertisement

Log in

Japan Diabetic Nephropathy Cohort Study: study design, methods, and implementation

  • Original Article
  • Published:
Clinical and Experimental Nephrology Aims and scope Submit manuscript

Abstract

Background

Diabetic nephropathy, leading to end-stage renal disease, has a considerable impact on public health and the social economy. However, there are few national registries of diabetic nephropathy in Japan. The aims of this prospective cohort study are to obtain clinical data and urine samples for revising the clinical staging of diabetic nephropathy, and developing new diagnostic markers for early diabetic nephropathy.

Methods

The Japanese Society of Nephrology established a nationwide, web-based, and prospective registry system. On the system, there are two basic registries; the Japan Renal Biopsy Registry (JRBR), and the Japan Kidney Disease Registry (JKDR). In addition to the two basic registries, we established a new prospective registry to the system; the Japan Diabetic Nephropathy Cohort Study (JDNCS), which collected physical and laboratory data.

Results

We analyzed the data of 321 participants (106 female, 215 male; average age 65 years) in the JDNCS. Systolic and diastolic blood pressure was 130.1 and 72.3 mmHg, respectively. Median estimated glomerular filtration rate (eGFR) was 33.3 ml/min/1.73 m2. Proteinuria was 1.8 g/gCr, and serum levels of albumin were 3.6 g/dl. The majority of the JDNCS patients presented with preserved eGFR and low albuminuria or low eGFR and advanced proteinuria. In the JRBR and JKDR registries, 484 and 125 participants, respectively, were enrolled as having diabetes mellitus. In comparison with the JRBR and JKDR registries, the JDNCS was characterized by diabetic patients presenting with low proteinuria with moderately preserved eGFR.

Conclusions

There are few national registries of diabetic nephropathy to evaluate prognosis in Japan. Future analysis of the JDNCS will provide clinical insights into the epidemiology and renal and cardiovascular outcomes of type 2 diabetic patients in Japan.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Wada T, Shimizu M, Toyama T, Hara A, Kaneko S, Furuichi K. Clinical impact of albuminuria in diabetic nephropathy. Clin Exp Nephrol. 2012;16:96–101.

    Article  PubMed  CAS  Google Scholar 

  2. Wada J, Makino H. Historical chronology of basic and clinical research in diabetic nephropathy and contributions of Japanese scientists. Clin Exp Nephrol. 2009;13:405–14.

    Article  PubMed  Google Scholar 

  3. Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, Tsuruya K, Kiyomoto H, Iida H, Sasaki T, Higuchi M, Hattori M, Oka K, Kagami S, Nagata M, Kawamura T, Honda M, Fukasawa Y, Fukatsu A, Morozumi K, Yoshikawa N, Yuzawa Y, Matsuo S, Kiyohara Y, Joh K, Taguchi T, Makino H. Japan Renal Biopsy Registry: the first nationwide, web-based, and prospective registry system of renal biopsies in Japan. Clin Exp Nephrol. 2011;15:493–503.

    Article  PubMed  Google Scholar 

  4. Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.

    Article  PubMed  CAS  Google Scholar 

  5. Ninomiya T, Perkovic V, de Galan BE, Zoungas S, Pillai A, Jardine M, Patel A, Cass A, Neal B, Poulter N, Mogensen CE, Cooper M, Marre M, Williams B, Hamet P, Mancia G, Woodward M, Macmahon S, Chalmers J. Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. J Am Soc Nephrol. 2009;20:1813–21.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bruno G, Merletti F, Bargero G, Novelli G, Melis D, Soddu A, Perotto M, Pagano G, Cavallo-Perin P. Estimated glomerular filtration rate, albuminuria and mortality in type 2 diabetes: the Casale Monferrato study. Diabetologia. 2007;50:941–8.

    Article  PubMed  CAS  Google Scholar 

  7. So WY, Kong AP, Ma RC, Ozaki R, Szeto CC, Chan NN, Ng V, Ho CS, Lam CW, Chow CC, Cockram CS, Chan JC, Tong PC. Glomerular filtration rate, cardiorenal end points, and all-cause mortality in type 2 diabetic patients. Diabetes Care. 2006;29:2046–52.

    Article  PubMed  Google Scholar 

  8. Nakai S, Masakane I, Shigematsu T, Hamano T, Yamagata K, Watanabe Y, Itami N, Ogata S, Kimata N, Shinoda T, Syouji T, Suzuki K, Taniguchi M, Tsuchida K, Nakamoto H, Nishi S, Nishi H, Hashimoto S, Hasegawa T, Hanafusa N, Fujii N, Marubayashi S, Morita O, Wakai K, Wada A, Iseki K, Tsubakihara Y. An overview of regular dialysis treatment in Japan (as of 31 December 2007). Ther Apher Dial. 2009;13:457–504.

    Article  PubMed  Google Scholar 

  9. Yokoyama H, Sone H, Oishi M, Kawai K, Fukumoto Y, Kobayashi M. Prevalence of albuminuria and renal insufficiency and associated clinical factors in type 2 diabetes: the Japan Diabetes Clinical Data Management study (JDDM15). Nephrol Dial Transplant. 2009;24:1212–9.

    Article  PubMed  CAS  Google Scholar 

  10. Caramori ML, Fioretto P, Mauer M. Low glomerular filtration rate in normoalbuminuric type 1 diabetic patients: an indicator of more advanced glomerular lesions. Diabetes. 2003;52:1036–40.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported in part by a Grant-in-Aid for Progressive Renal Diseases Research, Research on Rare and Intractable Disease, and a Grant-in-Aid for Diabetic Nephropathy and Nephrosclerosis Research, from the Ministry of Health, Labour and Welfare of Japan.

Conflict of interest

The authors have declared that no conflict of interest exists.

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to Takashi Wada.

About this article

Cite this article

Furuichi, K., Shimizu, M., Toyama, T. et al. Japan Diabetic Nephropathy Cohort Study: study design, methods, and implementation. Clin Exp Nephrol 17, 819–826 (2013). https://doi.org/10.1007/s10157-013-0778-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10157-013-0778-8

Keywords

Navigation