Baseline characteristics and prevalence of cardiovascular disease in newly visiting or referred chronic kidney disease patients to nephrology centers in Japan: a prospective cohort study

被引：28

作者：

Iimori, Soichiro ^{[1
,2
]}

Noda, Yumi ^{[1
,2
]}

Okado, Tomokazu ^{[1
,2
]}

Naito, Shotaro ^{[1
,2
]}

Toda, Takayuki ^{[3
]}

Chida, Yoshiko ^{[4
]}

Kuwahara, Michio ^{[5
]}

Ando, Ryoichi ^{[6
]}

Nishio, Yasuhide ^{[7
]}

Maeda, Yoshitaka ^{[8
]}

Tanaka, Hiroyuki ^{[9
]}

Tamura, Teiichi ^{[9
]}

Kimoto, Shigeaki ^{[10
]}

Kanda, Eiichiro ^{[11
]}

Inoshita, Seiji ^{[12
]}

Yoshikawa, Momono ^{[13
]}

Okutsu, Rie ^{[14
]}

Tajima, Masato ^{[15
]}

Kusaura, Takashi ^{[16
]}

Kobayashi, Katsuki ^{[17
]}

Rai, Tatemitsu ^{[1
]}

Uchida, Shinichi ^{[1
]}

Sasaki, Sei ^{[1
]}

机构：

[1] Tokyo Med & Dent Univ, Dept Nephrol, Tokyo 1138519, Japan

[2] Tokyo Med & Dent Univ, Dept Chron Kidney Dis, Tokyo 1138519, Japan

[3] Tsuchiura Kyodo Gen, Dept Nephrol, Tsuchiura, Ibaraki 3000053, Japan

[4] Nakano Gen Hosp, Dept Nephrol, Chuo Ku, Tokyo 1648607, Japan

[5] Shuuwa Gen Hosp, Dept Nephrol, Kasukabe, Saitama 3440035, Japan

[6] Musashino Red Cross Hosp, Dept Nephrol, Musashino, Tokyo 1808610, Japan

[7] Tokyo Metropolitan Tama Med Ctr, Dept Nephrol, Fuchu, Tokyo 1838524, Japan

[8] JA Toride Med Ctr, Dept Nephrol, Toride, Ibaraki 3020022, Japan

[9] Yokosuka Kyosai Hosp, Dept Nephrol, Yokosuka, Kanagawa 2388558, Japan

[10] Ome Municipal Gen Hosp, Dept Nephrol, Ome, Tokyo 1980042, Japan

[11] Tokyo Kyosai Hosp, Dept Nephrol, Meguro Ku, Tokyo 1538934, Japan

[12] Tokyo Metropolitan Bokutoh Hosp, Dept Internal Med, Tokyo 1308575, Japan

[13] Tokyo Metropolitan Otsuka Hosp, Dept Nephrol, Toshima Ku, Tokyo 1708476, Japan

[14] Toshima Hosp, Dept Nephrol, Itabashi Ku, Tokyo 1730015, Japan

[15] Tokyo Metropolitan Hiroo Gen Hosp, Dept Nephrol, Tokyo 0013, Japan

[16] Hiratsuka Kyosai Hosp, Dept Nephrol, Hiratsuka, Kanagawa 2548502, Japan

[17] Chiba East Natl Hosp, Clin Res Ctr, Chuo Ku, Chiba 2608712, Japan

来源：

BMC NEPHROLOGY | 2013年 / 14卷

关键词：

Chronic kidney disease; Cohort study; Epidemiology; Cardiovascular disease; Nephrologist; OUTCOMES; RISK; POPULATION; ALBUMINURIA; COMPONENTS; MORTALITY; STAGE-3; EVENTS; DEATH;

D O I：

10.1186/1471-2369-14-152

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background: About 39,000 patients were newly prescribed renal replacement therapy in Japan in 2011, resulting in a total of more than 300,000 patients being treated with dialysis. This high prevalence of treated end stage kidney disease (ESKD) patients is an emergent problem that requires immediate attention. We launched a prospective cohort study to evaluate population specific characteristics of the progression of chronic kidney disease (CKD). In this report, we describe the baseline characteristics and risk factors for cardiovascular disease (CVD) prevalence among this cohort. Methods: New patients from 16 nephrology centers who were older than 20 years of age and who visited or were referred for the treatment of CKD stage 2-5, but were not on dialysis therapy, were recruited in this study. At enrollment, medical history, lifestyle behaviors, functional status and current medications were recorded, and blood and urine samples were collected. Estimated glomerular filtration rate (eGFR) was calculated by a modified three-variable equation. Results: We enrolled 1138 patients, 69.6% of whom were male, with a mean age of 68 years. Compared with Western cohorts, patients in this study had a lower body mass index (BMI) and higher proteinuria. The prevalence of CVD was 26.8%, which was lower than that in Western cohorts but higher than that in the general Japanese population. Multivariate analysis demonstrated the following association with CVD prevalence: hypertension (adjusted odds ratio (aOR) 3.57; 95% confidence interval (CI) 1.82-7.02); diabetes (aOR 2.45; 95% CI 1.86-3.23); hemoglobin level less than 11 g/dl (aOR 1.61; 95% CI 1.21-2.15); receiving anti-hypertensive agents (aOR 3.54; 95% CI 2.27-5.53); and statin therapy (aOR 2.73; 95% CI 2.04-3.66). The combination of decreased eGFR and increased proteinuria was also associated with a higher prevalence of CVD. Conclusions: The participants in this cohort had a lower BMI, higher proteinuria and lower prevalence of CVD compared with Western cohorts. Lower eGFR and high proteinuria were associated with CVD prevalence. Prospective follow up of these study patients will contribute to establishment of individual population-based treatment of CKD.

引用

页数：11

共 23 条

[1]

[Anonymous], 2009, CLIN EXP NEPHROL, V13, P537

[2]

[Anonymous], 2012, NIHON JINZO GAKKAI S, V54, P1034

[3]

[Anonymous], 2012, FAO Statistical Yearbook

[4] Association of kidney function with anemia - The Third National Health and Nutrition Examination Survey (1988-1994) [J].

Astor, BC ;

Muntner, P ;

Levin, A ;

Eustace, JA ;

Coresh, J .

ARCHIVES OF INTERNAL MEDICINE, 2002, 162 (12) :1401-1408

[5] Outcomes of stage 3-5 chronic kidney disease before end-stage renal disease at a single center in Taiwan [J].

Chiu, Yen-Ling ;

Chien, Kuo-Liong ;

Lin, Shuei-Liong ;

Chen, Yung-Ming ;

Tsai, Tun-Jun ;

Wu, Kwan-Dun .

NEPHRON CLINICAL PRACTICE, 2008, 109 (03) :C109-C118

[6] Prevalence of chronic kidney disease in the United States [J].

Coresh, Josef ;

Selvin, Elizabeth ;

Stevens, Lesley A. ;

Manzi, Jane ;

Kusek, John W. ;

Eggers, Paul ;

Van Lente, Frederick ;

Levey, Andrew S. .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2007, 298 (17) :2038-2047

[7] Estimated glomerular filtration rate and albuminuria are independent predictors of cardiovascular events and death in type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study [J].

Drury, P. L. ;

Ting, R. ;

Zannino, D. ;

Ehnholm, C. ;

Flack, J. ;

Whiting, M. ;

Fassett, R. ;

Ansquer, J. -C. ;

Dixon, P. ;

Davis, T. M. E. ;

Pardy, C. ;

Colman, P. ;

Keech, A. .

DIABETOLOGIA, 2011, 54 (01) :32-43

[8] Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization [J].

Go, AS ;

Chertow, GM ;

Fan, DJ ;

McCulloch, CE ;

Hsu, CY .

NEW ENGLAND JOURNAL OF MEDICINE, 2004, 351 (13) :1296-1305

[9] Microalbuminuria is common, also in a nondiabetic, nonhypertensive population, and an independent indicator of cardiovascular risk factors and cardiovascular morbidity [J].

Hillege, HL ;

Janssen, WMT ;

Bak, AAA ;

Diercks, GFH ;

Grobbee, DE ;

Crijns, HJGM ;

van Gilst, WH ;

de Zeeuw, D ;

de Jong, PE .

JOURNAL OF INTERNAL MEDICINE, 2001, 249 (06) :519-526

[10] Factors Associated With Kidney Disease Progression and Mortality in a Referred CKD Population [J].

Hoefield, Richard A. ;

Kalra, Philip A. ;

Baker, Patricia ;

Lane, Beverley ;

New, John P. ;

O'Donoghue, Donal J. ;

Foley, Robert N. ;

Middleton, Rachel J. .

AMERICAN JOURNAL OF KIDNEY DISEASES, 2010, 56 (06) :1072-1081

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