Enyu Imai1, Masaru Horio2, Kunitoshi Iseki3, Kunihiro Yamagata4, Tsuyoshi Watanabe5, Shigeko Hara6, Nobuyuki Ura7, Yutaka Kiyohara8, Hideki Hirakata9, Toshiki Moriyama10, Yasuhiro Ando11, Kosaku Nitta12, Daijo Inaguma13, Ichiei Narita14, Hiroyasu Iso15, Kenji Wakai16, Yoshinari Yasuda17, Yusuke Tsukamoto18, Sadayoshi Ito19, Hirofumi Makino20, Akira Hishida21, Seiichi Matsuo17. 1. Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan. imai@medone.med.osaka-u.ac.jp. 2. Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Osaka, Japan. 3. Dialysis Unit, University Hospital of The Ryukyus, Okinawa, Japan. 4. Department of Nephrology, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan. 5. Third Department of Medicine, Fukushima Medical University, Fukushima, Japan. 6. Health Medical Center, Toranomon Hospital, Tokyo, Japan. 7. Second Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan. 8. Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 9. Nephrology and Dialysis Center, Fukuoka Red Cross Hospital, Fukuoka, Japan. 10. Healthcare Center, Osaka University, Osaka, Japan. 11. Department of Nephrology, Jichi Medical School, Tochigi, Japan. 12. Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan. 13. Tosei General Hospital, Aichi, Japan. 14. Division of Nephrology and Rheumatology, Niigata University, Niigata, Japan. 15. Department of Public Health, Osaka University Graduate School of Medicine, Osaka, Japan. 16. Aichi Cancer Institute, Japan. 17. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 18. Syuwa General Hospital, Japan. 19. Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan. 20. Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. 21. First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
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 m(2) instead of less than 60 ml/min per 1.73 m(2). 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 m(2).
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 ESRDpatients 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 m(2) instead of less than 60 ml/min per 1.73 m(2). 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 m(2).
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