Abstract
To compare the risk factor demographics and the prevalence of chronic kidney disease (CKD), we analyzed two databases from the 1993 (N=143,948) and 2003 (N=154,019) mass screenings in Okinawa, Japan (Okinawa General Health Maintenance Association registry). We estimated the glomerular filtration rate (GFR) using serum creatinine (SCr) levels. SCr was measured by the modified Jaffe method in 1993 and by enzyme assay in 2003; the relation between the two methods was: SCr (Jaffe) = 0.194 + 1.079 × SCr (enzyme). CKD prevalence was compared using the estimated GFR calculated by the abbreviated Modification of Diet in Renal Disease (MDRD) equation. SCr was measured in 66.2% (1993) and 69.8% (2003) of the total screenees. Proteinuria was present in 3.4% (1993) and 4.3% (2003) of the total screened population, respectively. The prevalence of CKD (GFR<60 ml/min/1.73 m2) was similar between the two databases, being 15.7% in 1993 and 15.1% in 2003. However, the demographics of the CKD risk factors changed during the study period. The mean level of systolic blood pressure decreased, whereas the prevalence of obesity and the mean levels of serum cholesterol and fasting plasma glucose increased. In 2003, the estimated prevalence of metabolic syndrome in the general population of Japan calculated using the modified National Cholesterol Education Program (NCEP) criteria was 19.1%. The prevalence of CKD was significantly associated with that of metabolic syndrome: the age- and sex-adjusted odds ratio was 1.332 (95% confidence interval [CI], 1.277–1.389; p<0.0001). In conclusion, the demographics of the participants of the general screenings in Okinawa, Japan differed between the 1993 and 2003 screenings, but the prevalence of CKD seemed to be similar, or at least did not increase substantially, between the two databases.
Similar content being viewed by others
Article PDF
References
Patient Registration Committee, Japanese Society for the Dialysis Therapy, Tokyo, Japan: An overview of regular dialysis treatment in Japan (as of December 31, 2002). Therap Nephrol Dial 2004; 8: 358–382.
US Renal Data System : Excerpts from the USRDS 2001 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. Am J Kidney Dis 2001; 38 ( Suppl 3): S1–S248.
Schena FP : Epidemiology of end-stage renal disease: international comparisons of renal replacement therapy. Kidney Int 2000; 57 ( Suppl 74): S39–S45.
Usami T, Koyama K, Takeuchi O, Morozumi K, Kimura G : Regional variation in the incidence of end-stage renal failure in Japan. JAMA 2000; 284: 2622–2624.
Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS : Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2003; 41: 1–12.
Coresh J, Byrd-Holt D, Astor BC, et al: Chronic kidney disease awareness, prevalence, and trends among U.S. adults, 1999 to 2000. J Am Soc Nephrol 2005; 16: 180–188.
Sarnak MJ, Levey AS, Schoolwerth AC, American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention: Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation 2003; 108: 2154–2169.
Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D : Predictors of new-onset kidney disease in a community-based population. JAMA 2004; 291: 844–850.
Iseki K, Wakugami K, Maehara A, Tozawa M, Muratani H, Fukiyama K : Evidence for high incidence of end-stage renal disease in patients after stroke and acute myocardial infarction at age 60 or younger. Am J Kidney Dis 2001; 38: 1235–1239.
Iseki K, Kimura Y, Wakugami K, et al: Comparison of the effect of blood pressure on the development of stroke, acute myocardial infarction, and end-stage renal disease. Hypertens Res 2000; 23: 143–149.
Iseki K : Factors influencing development of end-stage renal disease. Clin Exp Nephrol 2005; 9: 5–14.
Ruggenenti P, Fassi A, Ilieva AP, et al: Preventing microalbuminuria in type 2 diabetes. N Engl J Med 2004; 351: 1941–1951.
Brenner BM, Cooper ME, De Zeeuw D, et al, the RENAAL Study Investigators: Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001; 345: 861–869.
Nakao N, Yoshimura A, Morita H, Takada M, Kayano T, Ideura T : Combination treatment of angiotensin-II receptor blocker and angiotensin-converting–enzyme inhibitor in non-diabetic renal disease (COOPERATE): a randomized controlled trial. Lancet 2003; 361: 117–124.
Yamagata K, Takahashi H, Suzuki S, et al: Age distribution and yearly changes in the incidence of ESRD in Japan. Am J Kidney Dis 2004; 43: 433–443.
Yamagata K, Yamagata Y, Kobayashi M, Koyama A : A long-term follow-up study of asymptomatic hematuria and/or proteinuria in adults. Clin Nephrol 1996; 45: 281–288.
Murakami M, Yamamoto H, Ueda Y, Murakami K, Yamauchi K : Urinary screening of elementary and junior high-school children over a 13-year period in Tokyo. Pediatr Nephrol 1991; 5: 50–53.
Iseki K, Iseki C, Ikemiya Y, Fukiyama K : Risk of developing end-stage renal disease in a cohort of mass screening. Kidney Int 1996; 49: 800–805.
Iseki K, Ikemiya Y, Fukiyama K : Risk factors of end-stage renal disease and serum creatinine in a community-based mass screening. Kidney Int 1997; 51: 850–854.
Iseki K, Ikemiya Y, Iseki C, Takishita S : Proteinuria and the risk of developing end-stage renal disease. Kidney Int 2003; 63: 1468–1474.
Iseki K, Kawazoe N, Osawa A, Fukiyama K : Survival analysis of dialysis patients in Okinawa, Japan (1971–1990). Kidney Int 1993; 43: 404–409.
Iseki K, Tozawa M, Iseki C, Takishita S, Ogawa Y : Demographic trends in the Okinawa Dialysis Study (OKIDS) registry (1971–2000). Kidney Int 2002; 61: 668–675.
Tanaka H, Shiohira Y, Uezu Y, Higa A, Iseki K : Metabolic syndrome and chronic kidney disease in Okinawa, Japan. Kidney Int 2006; 69: 369–376.
Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D : A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med 1999; 130: 461–470.
National Kidney Foundation : K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease. Evaluation, Classification, and Stratification. Am J Kidney Dis 2002; 39 ( Suppl 1): S170–S212.
National Cholesterol Education Program : Executive Summary of the Third Report of National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adults Treatment Panel III). JAMA 2001; 285: 2486–2497.
Orita Y, Okada M, Harada S, Horio M : Skim soy protein enhances GFR as much as beefsteak protein in healthy human subjects. Clin Exp Nephrol 2004; 8: 103–108.
Hosoya T, Toshima R, Icida K, Tabe A, Sakai O : Changes in renal function with aging among Japanese. Intern Med 1995; 34: 520–527.
Domrongkitchaiporn S, Sritara P, Kitiyakara C, et al: Risk factors for development of decreased kidney function in a Southeast Asian population: a 12-year cohort study. J Am Soc Nephrol 2005; 16: 791–799.
Chen J, Muntner P, Hamm LL, et al: The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med 2004; 140: 167–174.
Li PK, Weening JJ, Dirks J, et al: A report with consensus statements of the International Society of Nephrology 2004 Consensus Workshop on Prevention of Progression of Renal Disease, Hong Kong, June 29, 2004. Kidney Int Suppl 2005; 94: S2–S7.
Iseki K, Kinjo K, Iseki C, Takishita S : Relationship between predicted creatinine clearance and proteinuria and the risk of developing ESRD in Okinawa, Japan. Am J Kidney Dis 2004; 44: 806–814.
Kambham N, Markowitz GS, Valeri AM, Lin J, D'Agati VD : Obesity-related glomerulopathy: an emerging epidemic. Kidney Int 2001; 59: 1498–1509.
Iseki K, Ikemiya Y, Kinjo K, Inoue T, Iseki C, Takishita S : Body mass index and the risk of development of end-stage renal disease in a screened cohort. Kidney Int 2004; 65: 1870–1876.
Guidelines Subcommittee of the Japanese Society of Hypertension: Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2000). Guidelines Subcommittee of the Japanese Society of Hypertension, Tokyo, Japan 2000.
Tanemoto M, Saitoh H, Satoh F, et al: Predictors of undiagnosed renal artery stenosis among Japanese patients with risk factors of atherosclerosis. Hypertens Res 2005; 28: 237–242.
Tozawa M, Iseki K, Iseki C, Oshiro S, Ikemiya Y, Takishita S : Influence of smoking and obesity on the development of proteinuria. Kidney Int 2002; 62: 956–962.
Metcalf P, Baker J, Scott A, Wild C, Scragg R, Dryson E : Albuminuria in people at least 40 years old: effect of obesity, hypertension, and hyperlipidemia. Clin Chem 1992; 38: 1802–1808.
Praga M, Hernandez E, Andres A, Leon M, Ruilope LM, Rodicio JL : Effects of body-weight loss and captopril treatment on proteinuria associated with obesity. Nephron 1995; 70: 35–41.
Zuo L, Ma YC, Zhou YH, Wang M, Xu GB, Wang HY : Application of GFR-estimating equations in Chinese patients with chronic kidney disease. Am J Kidney Dis 2005; 45: 463–472.
Hu G, Lindstrom J, Valle TT, et al: Physical activity, body mass index, and risk of type 2 diabetes in patients with normal or impaired glucose regulation. Arch Intern Med 2004; 164: 892–896.
Howard AA, Amsten JH, Gourevitch MN : Effect of alcohol consumption on diabetes mellitus. Ann Intern Med 2004; 140: 211–219.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Iseki, K., Kohagura, K., Sakima, A. et al. Changes in the Demographics and Prevalence of Chronic Kidney Disease in Okinawa, Japan (1993 to 2003). Hypertens Res 30, 55–62 (2007). https://doi.org/10.1291/hypres.30.55
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1291/hypres.30.55
Keywords
This article is cited by
-
Clinical prediction models for progression of chronic kidney disease to end-stage kidney failure under pre-dialysis nephrology care: results from the Chronic Kidney Disease Japan Cohort Study
Clinical and Experimental Nephrology (2019)
-
Kidney and eye diseases: common risk factors, etiological mechanisms, and pathways
Kidney International (2014)
-
Improved accuracy for the detection of sleep apnea-related surges in blood pressure
Hypertension Research (2011)
-
Risk factors for chronic kidney disease in Japan: a community-based study
BMC Nephrology (2009)
-
Impact of reduced renal function on prognosis in Japanese patients with coronary artery disease: a prospective cohort of Shinken Database 2007
Hypertension Research (2009)
