Clinical and Experimental Nephrology

, Volume 22, Issue 1, pp 55–60 | Cite as

Premature mortality due to nephrotic syndrome and the trend in nephrotic syndrome mortality in Japan, 1995–2014

  • Minako WakasugiEmail author
  • Junichiro James Kazama
  • Ichiei Narita
Original article



This study analysed the trend in mortality from nephrotic syndrome in Japan from 1995 to 2013. Moreover, to better understand premature death from nephrotic syndrome, the average years of life lost due to nephrotic syndrome were estimated.


National death certificate data were evaluated. Age-standardised mortality rates from nephrotic syndrome were calculated by direct standardisation using the World Standard Population. Trends for average annual changes in percentages were determined by joinpoint regression analysis. Average years of life lost were estimated by dividing total years of life lost by the number of deaths from nephrotic syndrome. Years of life lost were estimated by the constant end-point method, with 65 years as the endpoint. Average years of life lost due to malignant neoplasms, the leading cause of death in Japan, were estimated for comparison.


There were 9945 deaths (4872 men and 5073 women) during the study period. The numbers of deaths and crude overall mortality rates increased, while age-standardised mortality rates continuously decreased, for both sexes. The annual percentage changes were −1.9% [95% confidence interval (CI), −2.3 to −1.4%] for men and −3.5% (95% CI −4.1 to −2.9%) for women. The average years of life lost due to nephrotic syndrome decreased during the study period, but were greater than for patients who died of malignant neoplasm.


Mortality and premature mortality rates from nephrotic syndrome significantly decreased in Japan between 1995 and 2014. Despite these improvements, nephrotic syndrome patients ≤65 years of age still have a poor prognosis.


Epidemiology Joinpoint regression Nephrotic syndrome Premature death Secular trends Years of life lost 


Compliance with ethical standards

Conflict of interest

All the authors have declared no competing interest.

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Obtaining consent to participate is not required, because the current analyses used existing national data without any individual patient data.

Supplementary material

10157_2017_1417_MOESM1_ESM.docx (23 kb)
Supplementary material 1 (DOCX 22 kb)


  1. 1.
    Hull RP, Goldsmith DJ. Nephrotic syndrome in adults. BMJ. 2008;336:1185–9.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Kerlin BA, Ayoob R, Smoyer WE. Epidemiology and pathophysiology of nephrotic syndrome-associated thromboembolic disease. Clin J Am Soc Nephrol. 2012;7:513–20.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Wu HM, Tang JL, Cao L, et al. Interventions for preventing infection in nephrotic syndrome. Cochrane Database Syst Rev. 2012;4:Cd003964.Google Scholar
  4. 4.
    Singhal R, Brimble KS. Thromboembolic complications in the nephrotic syndrome: pathophysiology and clinical management. Thromb Res. 2006;118:397–407.CrossRefPubMedGoogle Scholar
  5. 5.
    Moorani KN, Khan KM, Ramzan A. Infections in children with nephrotic syndrome. J Coll Physicians Surg Pak. 2003;13:337–9.PubMedGoogle Scholar
  6. 6.
    Burnet NG, Jefferies SJ, Benson RJ, et al. Years of life lost (YLL) from cancer is an important measure of population burden—and should be considered when allocating research funds. Br J Cancer. 2005;92:241–5.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Fontaine KR, Redden DT, Wang C, et al. Years of life lost due to obesity. JAMA. 2003;289:187–93.CrossRefPubMedGoogle Scholar
  8. 8.
    Bureau. S. Portal site of official statistics of Japan. Accessed 1 Dec 2016.
  9. 9.
    Doi Y, Yokoyama T, Nakamura Y, et al. How can the national burden of Parkinson’s disease comorbidity and mortality be estimated for the Japanese population? J Epidemiol. 2011;21:211–6.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Wakasugi M, Kawamura K, Yamamoto S, et al. High mortality rate of infectious diseases in dialysis patients: a comparison with the general population in Japan. Ther Apher Dial. 2012;16:226–31.CrossRefPubMedGoogle Scholar
  11. 11.
    Wakasugi M, Kazama JJ, Yamamoto S, et al. Cause-specific excess mortality among dialysis patients: comparison with the general population in Japan. Ther Apher Dial. 2013;17:298–304.CrossRefPubMedGoogle Scholar
  12. 12.
    Statistics Bureau, Ministry of Internal Affairs and Communications. Population by Age (single year) and Sex (as of October 1 of each year)—Total population, Japanese population (from 2000 to 2010). Accessed 1 Dec 2016.
  13. 13.
    Statistics Bureau. Population Estimates of Japan 1920–2000. Accessed 1 Dec 2016.
  14. 14.
    Kim HJ, Fay MP, Feuer EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med. 2000;19:335–51.CrossRefPubMedGoogle Scholar
  15. 15.
    Wakasugi M, Kazama JJ, Narita I. Mortality trends among Japanese dialysis patients, 1988-2013: a joinpoint regression analysis. Nephrol Dial Transplant. 2016;31:1501–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Yoshida K, Sugimori H, Yamada Y, et al. Years of potential life lost as the indicator of premature mortality in occupational medicine. Environ Health Prev Med. 1997;2:40–4.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Tu JV. Life expectancy and years of potential life lost: useful outcome measures in cardiovascular medicine? J Am Coll Cardiol. 2015;66:656–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Goldacre MJ, Duncan ME, Cook-Mozaffari P, Griffith M. Trends in mortality rates comparing underlying-cause and multiple-cause coding in an English population 1979–1998. J Public Health Med. 2003;25:249–53.CrossRefPubMedGoogle Scholar
  19. 19.
    Ministry of Health, Labour and Welfare (Japan). Complete life tables. 2016. (in Japanese). Accessed 1 Dec 2016.
  20. 20.
    Ayoob RM, Hains DS, Smoyer WE. Trends in hospitalization characteristics for pediatric nephrotic syndrome in the USA. Clin Nephrol. 2012;78:106–11.CrossRefPubMedGoogle Scholar
  21. 21.
    Yoshino M, Kuhlmann MK, Kotanko P, et al. International differences in dialysis mortality reflect background general population atherosclerotic cardiovascular mortality. J Am Soc Nephrol. 2006;17:3510–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Brustugun OT, Møller B, Helland A. Years of life lost as a measure of cancer burden on a national level. Br J Cancer. 2014;111:1014–20.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Guo Y, Li S, Tian Z, et al. The burden of air pollution on years of life lost in Beijing, China, 2004–08: retrospective regression analysis of daily deaths. BMJ. 2013;347:f7139.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Japanese Society of Nephrology 2017

Authors and Affiliations

  1. 1.Division of Comprehensive Geriatrics in CommunityNiigata University Graduate School of Medical and Dental ScienceNiigataJapan
  2. 2.Departments of Nephrology and HypertensionFukushima Medical UniversityFukushimaJapan
  3. 3.Division of Clinical Nephrology and RheumatologyNiigata University Graduate School of Medical and Dental ScienceNiigataJapan

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