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Comparison of annual eGFR decline among primary kidney diseases in patients with CKD G3b-5: results from a REACH-J CKD cohort study

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Abstract

Background

Disease-specific trajectories of renal function in advanced chronic kidney disease (CKD) are not well defined. Here, we compared these trajectories in the estimated glomerular filtration rate (eGFR) by CKD stages.

Methods

Patients with multiple eGFR measurements during the 5-year preregistration period of the REACH-J study were enrolled. Mean annual eGFR declines were calculated from linear mixed effect models with the adjustment variables of baseline CKD stage, age, sex and the current CKD stage and the level of proteinuria (CKDA1-3).

Results

Among 1,969 eligible patients with CKDG3b-5, the adjusted eGFR decline (ml/min/1.73 m2/year) was significantly faster in diabetic kidney disease (DKD) patients and polycystic kidney disease (PKD) patients than in patients with other kidney diseases (DKD, − 2.96 ± 0.13; PKD, − 2.82 ± 0.17; and others, − 1.95 ± 0.05, p < 0.01). The declines were faster with higher CKD stages. In DKD patients, the eGFR decline was significantly faster in CKDG5 than CKDG4 (− 4.10 ± 0.18 vs − 2.76 ± 0.20, p < 0.01), while these declines in PKD patients were similar. The eGFR declines in PKD patients were significantly faster than DKD patients in CKDG4 (− 2.92 ± 0.23 vs − 2.76 ± 0.20, p < 0.01) and in CKDA2 (− 3.36 ± 0.35 vs − 1.40 ± 0.26, p < 0.01).

Conclusion

Our study revealed the disease-specific annual eGFR declines by CKD stages and the level of proteinuria. Comparing to the other kidney diseases, the declines in PKD patients were getting faster from early stages of CKD. These results suggest the importance of CKD managements in PKD patients from the early stages.

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References

  1. Matsushita K, van der Velde M, Astor BC, Woodward M, Levey AS, de Jong PE, et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375:2073–81.

    Article  Google Scholar 

  2. Wang V, Vilme H, Maciejewski ML, Boulware LE. The economic burden of chronic kidney disease and end-stage renal disease. Semin Nephrol. 2016;36:319–30.

    Article  Google Scholar 

  3. Zelmer JL. The economic burden of end-stage renal disease in Canada. Kidney Int. 2007;72:1122–9.

    Article  CAS  Google Scholar 

  4. Ismail H, Abdul Manaf MR, Abdul Gafor AH, Mohamad Zaher ZM, Ibrahim AIN. Economic burden of ESRD to the Malaysian Health Care System. Kidney Int Rep. 2019;4:1261–70.

    Article  Google Scholar 

  5. Sumida K, Molnar MZ, Potukuchi PK, Thomas F, Lu JL, Jing J, et al. Association of slopes of estimated glomerular filtration rate with post-end-stage renal disease mortality in patients with advanced chronic kidney disease transitioning to dialysis. Mayo Clin Proc. 2016;91:196–207.

    Article  Google Scholar 

  6. Hoshino J, Nagai K, Kai H, Saito C, Ito Y, Asahi K, et al. A nationwide prospective cohort study of patients with advanced chronic kidney disease in Japan: the Reach-J CKD cohort study. Clin Exp Nephrol. 2018;22:309–17.

    Article  Google Scholar 

  7. Mariani L, Stengel B, Combe C, Massy ZA, Reichel H, Fliser D, et al. The chronic kidney disease outcomes and practice patterns study (CKDopps): rationale and methods. Am J Kidney Dis. 2016;68:402–13.

    Article  Google Scholar 

  8. Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.

    Article  CAS  Google Scholar 

  9. Levin A, Stevens PE. Summary of KDIGO 2012 CKD Guideline: behind the scenes, need for guidance, and a framework for moving forward. Kidney Int. 2014;85:49–61.

    Article  Google Scholar 

  10. Sumida K, Nadkarni GN, Grams ME, Sang Y, Ballew SH, Coresh J, et al. Conversion of urine protein-creatinine ratio or urine dipstick protein to urine albumin-creatinine ratio for use in chronic kidney disease screening and prognosis: an individual participant-based meta-analysis. Ann Intern Med. 2020;173(6):426–35.

    Article  Google Scholar 

  11. Torres VE, Chapman AB, Devuyst O, Gansevoort RT, Grantham JJ, Higashihara E, et al. Tolvaptan in patients with autosomal dominant polycystic kidney disease. N Engl J Med. 2012;367:2407–18.

    Article  CAS  Google Scholar 

  12. Muto S, Kawano H, Higashihara E, Narita I, Ubara Y, Matsuzaki T, et al. The effect of tolvaptan on autosomal dominant polycystic kidney disease patients: a subgroup analysis of the Japanese patient subset from TEMPO 3:4 trial. Clin Exp Nephrol. 2015;19:867–77.

    Article  CAS  Google Scholar 

  13. Higashihara E, Horie S, Muto S, Mochizuki T, Nishio S, Nutahara K. Renal disease progression in autosomal dominant polycystic kidney disease. Clin Exp Nephrol. 2012;16:622–8.

    Article  Google Scholar 

  14. Leehey DJ, Kramer HJ, Daoud TM, Chatha MP, Isreb MA. Progression of kidney disease in type 2 diabetes – beyond blood pressure control: an observational study. BMC Nephrol. 2005;6:8.

    Article  Google Scholar 

  15. Vistisen D, Andersen GS, Hulman A, Persson F, Rossing P, Jørgensen ME. Progressive decline in estimated glomerular filtration rate in patients with diabetes after moderate loss in kidney function—even without albuminuria. Diabetes Care. 2019;42:1886–94.

    Article  Google Scholar 

  16. Koye DN, Magliano DJ, Reid CM, Jepson C, Feldman HI, Herman WH, et al. Risk of progression of nonalbuminuric CKD to end-stage kidney disease in people with diabetes: the CRIC (Chronic Renal Insufficiency Cohort) study. Am J Kidney Dis. 2018;72(5):653–61.

    Article  Google Scholar 

  17. So WY, Kong AP, Ma RC, Ozaki R, Szeto CC, Chan NN, et al. Glomerular filtration rate, cardiorenal end points, and all-cause mortality in type 2 diabetic patients. Diabetes Care. 2006;29:2046–52.

    Article  Google Scholar 

Download references

Acknowledgements

We thank all the nephrology specialists in Japan who responded to our Reach-J survey, Ms. Yukiko Ito and all the staff members of the Tsukuba Clinical Research & Development Organization (T-CReDO), University of Tsukuba, Mr. Yoshihiro Ishihara and other staff members of Flexible Inc., and Mr. Justin Albert, Mr. Brian Bieber, and all the staff members of Arbor Research, for their contribution to our work. We also thank Prof. Hideo Yasunaga and Dr. Nobuaki Michihata, the University of Tokyo, for statistical advice. The REACH-J CKD collaborators: Dr. Tomoya Hirayama, Kitasaito hospital, Hokkaido; Dr. Nobuhiko Togashi, JR Sapporo hospital, Hokkaido; Dr. Akira Sugiura, Osaki Citizen hospital, Miyagi; Dr. Kunihiro Yamagata, University of Tsukuba, Ibaraki; Dr. Tatsuo Shiigai, Shiigai clinic, Ibaraki; Dr. Kazue Ueki, Toho hospital, Gunma; Dr. Ken Kikkawa, Kikkawa Naika clinic, Saitama; Dr. Tsukasa Nakamura, Shinmatudo Central General Hospital, Chiba; Dr. Hideki Matsukuma, Funabashi Futawa hospital, Chiba; Dr. Shinsuke Harasawa, Nihon University hospital, Tokyo; Dr. Yuko Shibuya, NTT Medical Center Tokyo, Tokyo; Dr. Hitoshi Tagawa, Kichijoji Asahi Hospital; Dr. Shuzo Kobayashi, Shonan-Kamakura General Hospital, Kanagawa; Dr. Masaki Nagasawa, Shinonoi General Hospital, Nagano; Dr. Minako Wakasugi, Niigata University Hospital, Niigata; Dr. Hajime Yamazaki, Nagaoka Red Cross Hospital, Niigata; Dr. Michio Matsumoto, Toyama Saiseikai Toyama Hospital, Toyama; Dr. Shoichi Maruyama, Nagoya University Hospital, Aichi; Dr. Norihiro Suga, Nagoya City West Medical Center, Aichi; Dr. Keiichi Tamagaki, Kyoto Prefectural University of Medicine Hospital, Kyoto; Dr. Dr. Taiko Kimura, Nantan Hospital, Kyoto; Dr. Tsutomu Tabata, Inoue Hospital, Osaka; Dr. Shinichi Nishi, Kobe University Hospital, Hyogo; Dr. Yuriko Yonekura, Akashi Medical Center, Hyogo; Dr. Hitoshi Sugiyama, Okayama University Hospital, Okayama; Dr. Naoki Kashihara, Kawasaki Medical School Hospital, Okayama; Dr. Tadashi Sofue, Kagawa University hospital, Kagawa; Dr. Kazuhiko Tsuruya, Kyushu University Hospital, Fukuoka; Dr. Masato Tadokoro, Nagasaki Harbor Medical Center City Hospital, Nagasaki; Dr. Shoichi Fujimoto, University of Miyazaki Hospital, Miyazaki; and Dr. Kiyoyuki Tokuyama, Tokuyama Clinic, Okinawa.

Funding

The study was supported by a Grant-in-Aid for Research on Advanced Chronic Kidney Disease, Practical Research Project for Renal Diseases from the Japan Agency for Medical Research and Development. Preparation of the manuscript was supported in part by JH’s grant from Grants-in-Aid for Scientific Research (JSPS KAKENHI Grant Numbers 15K08719 and 18K08227, and the Okinaka Memorial Institute for Medical Research.

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Authors and Affiliations

  1. Nephrology Center, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan

    Junichi Hoshino

  2. Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Ryoya Tsunoda, Kei Nagai, Hirayasu Kai, Chie Saito & Kunihiro Yamagata

  3. Tsukuba Clinical Research & Development Organization (T-CReDO), University of Tsukuba, Tsukuba, Ibaraki, Japan

    Yukiko Ito

  4. Department of Nephrology and Hypertension, Iwate Medical University, Morioka, Japan

    Koichi Asahi

  5. Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan

    Masahide Kondo

  6. Okinawa Heart and Renal Association, Naha, Okinawa, Japan

    Kunitoshi Iseki & Chiho Iseki

  7. Department of Nephrology, Saitama Medical University, Saitama, Japan

    Hirokazu Okada

  8. Department of Nephrology and Hypertension, Kawasaki Medical School, Okayama, Japan

    Naoki Kashihara

  9. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan

    Ichiei Narita

  10. Department of Nephrology and Laboratory Medicine, Kanazawa University, Ishikawa, Japan

    Takashi Wada

  11. Unité INSERM 1026 Biotis, Univ. Bordeaux, Bordeaux, France

    Christian Combe

  12. Arbor Research Collaborative for Health, Ann Arbor, MI, USA

    Ronald L. Pisoni & Bruce M. Robinson

Authors
  1. Junichi Hoshino
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  2. Ryoya Tsunoda
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  11. Hirokazu Okada
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  13. Ichiei Narita
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  14. Takashi Wada
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  15. Christian Combe
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  16. Ronald L. Pisoni
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  17. Bruce M. Robinson
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  18. Kunihiro Yamagata
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Corresponding authors

Correspondence to Junichi Hoshino or Kunihiro Yamagata.

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Conflict of interest

J.H. has received a research grant from Otsuka Pharmaceutical Co. H.O is funded by Takeda Pharm., Chugai Pharm., Kyowa-Hakko Kirin, Pfizer, Boehinger Ingelheim, Astellas Pharm., Otsuka Pharm., MSD, Shionogi, Novaltis, Sumitomo Dainippon Pharm., Mitsubishi Tanabe Pharm., and Daiichi Sankyo Co. B.R and R.P. are members of Clinical Research for the non-profit organization Arbor Research Collaborative for health, which has designed and carried out the Dialysis Outcomes and Practice Pattern Study (DOPPS) Program. The DOPPS program is supported by Amgen, Kyowa Hakko Kirin, AbbVie Inc., Sanofi Renal, Baxter Healthcare, and Vifor Fresenius Medical Care Renal Pharma Ltd. Additional support for specific projects and countries is also provided in Canada by Amgen, BHC Medical, Janssen, Takeda, Kidney Foundation of Canada (for logistics support); in Germany by Hexal, DGfN, Shire, WiNe Institute; and for the Peritoneal-DOPPS in Japan by the Japanese Society for Peritoneal Dialysis (JSPD). The DOPPS.org website lists the full details. JDOPPS was administered by the Arbor Research Collaborative for Health, Ann Arbor, MI, USA, and supported by Kyowa Hakko Kirin Co. Ltd. All support is provided without restrictions on publications. All other authors have no conflict disclosure.

Human and animal rights

The study’s protocol was approved by the Tsukuba institutional review board (IRB) (H27-199) and the review board of the Japanese Society of Nephrology (No. 29), and has been or will be approved by the IRB of each participating facility. The study procedures fully adhered to the Declaration of Helsinki and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement, and was registered with the University Hospital Medical Information Network (UMIN000022145).

Informed consent

Informed consent was and will be obtained from all individual participants included in the study.

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Supplementary Information

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10157_2021_2059_MOESM1_ESM.pdf

Figure S1: Flowchart of the classification of primary kidney diseases. Two-digit numbers before disease names were kidney disease codes used in the REACH-J study. TMA, thrombotic microangiopathy; MPGN, membranoproliferative glomerulonephritis. (PDF 476 KB)

Supplementary file2 (PDF 275 KB)

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Hoshino, J., Tsunoda, R., Nagai, K. et al. Comparison of annual eGFR decline among primary kidney diseases in patients with CKD G3b-5: results from a REACH-J CKD cohort study. Clin Exp Nephrol 25, 902–910 (2021). https://doi.org/10.1007/s10157-021-02059-y

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