Risk factor profiles based on estimated glomerular filtration rate and dipstick proteinuria among participants of the Specific Health Check and Guidance System in Japan 2008
Risk factor profiles based on estimated glomerular filtration rate and dipstick proteinuria among participants of the Specific Health Check and Guidance System in Japan 2008
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DOI：
10.1007/s10157-011-0551-9
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发表时间：
2012-04-01
影响因子：
2.3
通讯作者：
Watanabe, Tsuyoshi
中科院分区：
文献类型：
--
作者：
Iseki, Kunitoshi;Asahi, Koichi;Watanabe, Tsuyoshi
估计的肾小球滤过率（eGFR）和白蛋白尿（蛋白尿）都是心血管疾病（CVD）、终末期肾病（ESRD）和死亡率风险的重要决定因素。但是，在一般人群中，以eGFR和蛋白尿为基础的危险因素的研究很少，本研究使用了2008年开始的特定健康检查指导系统（Tokutei-Kensin）新开发的全国性筛查项目的数据。这项筛查的目标是40-74岁的人群，旨在检测代谢综合征患者，并提供有关生活方式改变的服务，以减少糖尿病（DM）和DM相关的ESRD。本研究以匿名方式提供了日本全国69个城市和城镇以及3个工会队列的580，000名参与者的个人记录，并分析了332，174名参与者（占总数的57.3%）的血清肌酐和试纸尿液检测数据的详细信息。平均（SD）年龄为63.6（8.3）岁，40.6%为男性。平均（SD）eGFR为75.0（16.2）ml/min/1.73 m2，5.4%有蛋白尿。慢性肾脏病（CKD）3期、4期和5期的患病率分别为14.2%、0.2%和0.07%。糖尿病，高血压，中风和心脏病史的患病率与eGFR和蛋白尿程度的组合相关。本研究的结果表明，CKD和心血管疾病的危险因素是相当普遍的中年日本人。在日本人群中，基于eGFR和蛋白尿的CKD分类可能有助于预测CVD、死亡率和ESRD。
Estimated glomerular filtration rate (eGFR) and albuminuria (proteinuria) are both important determinants of the risk of cardiovascular disease (CVD), end-stage renal disease (ESRD), and mortality. Few studies, however, have examined the risk factor profiles based on eGFR and proteinuria among the general population.Data of the newly developed nationwide screening program of the Specific Health Check-up and Guidance System (Tokutei-Kensin) initiated in 2008 were used in this study. The aim of this screening, targeting people 40-74 years of age, was to detect those with metabolic syndrome and to offer those services regarding lifestyle modifications that will lead to the reduction of diabetes mellitus (DM) and DM-related ESRD. Individual records of 580,000 participants in 69 cities and towns and 3 union cohorts throughout Japan were anonymously provided and included in the present study.Details of 332,174 participants (57.3% of the total) with both serum creatinine and dipstick urine test data were analyzed. Mean (SD) age was 63.6 (8.3) years and 40.6% were men. The mean (SD) eGFR was 75.0 (16.2) ml/min/1.73 m(2) and 5.4% had proteinuria. The prevalence of chronic kidney disease (CKD) stage 3, 4, and 5 was 14.2%, 0.2%, and 0.07%, respectively. The prevalence of DM, hypertension, and history of stroke and heart disease was correlated with the combination of eGFR and degree of proteinuria.The findings of the present study indicate that CKD and risk factors for CVD are quite common among middle-aged Japanese. CKD classification based on eGFR and proteinuria may be useful for predicting CVD, mortality rate, and ESRD in the Japanese population.