Different regional dynamics of end-stage renal disease in Japan by different causes

被引:10
作者
Kato, N [1 ]
Usami, T [1 ]
Fukuda, M [1 ]
Motokawa, M [1 ]
Kamiya, Y [1 ]
Yoshida, A [1 ]
Kimura, G [1 ]
机构
[1] Nagoya City Univ, Grad Sch Med Sci, Dept Internal Med & Pathophysiol, Mizuho Ku, Nagoya, Aichi 4678601, Japan
关键词
chronic kidney disease; diabetic nephropathy; end-stage renal disease; glomerulonephritis; polycystic kidney disease; regional difference;
D O I
10.1111/j.1440-1797.2005.00404.x
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: We recently showed that there were clear regional differences in the dynamics of end-stage renal disease (ESRD) within Japan, which has an ethnically homogenous population. We speculate on the reason for these regional differences by correlating the regional distributions in the incidence of ESRD due to each of the following individual causes of ESRD: chronic glomerulonephritis (CGN), diabetic nephropathy (DMN) and polycystic kidney disease (PKD). Methods: The number of ESRD patients entering maintenance dialysis therapy due to individual causes of renal disease in each prefecture was reported annually for a 6-year period by the Japanese Society for Dialysis Therapy. After combining data from several prefectures into 11 geopolitical regions in Japan, the mean annual incidence of ESRD across the 11 regions was correlated among the three causes of ESRD. Results: There were significant regional differences in the incidence of ESRD due to CGN (P < 0.0001) and DMN (P = 0.0015), the distributions of which were similar to each other across the 11 regions. In contrast, no regional differences were found in the incidence of ESRD due to PKD (P = 0.6) as the major genetic disorder of the kidneys, suggesting that genetic backgrounds are relatively uniform throughout Japan. The regional distributions due to PKD were not correlated with those due to other causes: CGN and DMN. Conclusion: Risk factors common to nephropathy progression, rather than an underlying disease incidence and genetic predisposition, might contribute to regional differences in the overall ESRD incidence in Japan. Other possibilities such as the prevalence of underlying diseases, and acceptance or rejection rates into treatment programmes must be considered further for better explanations.
引用
收藏
页码:400 / 404
页数:5
相关论文
共 32 条
[1]   Effect of ramipril vs amlodipine on renal outcomes in hypertensive nephrosclerosis - A randomized controlled trial [J].
Agodoa, LY ;
Appel, L ;
Bakris, GL ;
Beck, G ;
Bourgoignie, J ;
Briggs, JP ;
Charleston, J ;
Cheek, D ;
Cleveland, W ;
Douglas, JG ;
Douglas, M ;
Dowie, D ;
Faulkner, M ;
Gabriel, A ;
Gassman, J ;
Greene, T ;
Hall, Y ;
Hebert, L ;
Hiremath, L ;
Jamerson, K ;
Johnson, CJ ;
Kopple, J ;
Kusek, J ;
Lash, J ;
Lea, J ;
Lewis, JB ;
Lipkowitz, M ;
Massry, S ;
Middleton, J ;
Miller, ER ;
Norris, K ;
O'Connor, D ;
Ojo, A ;
Phillips, RA ;
Pogue, V ;
Rahman, M ;
Randall, OS ;
Rostand, S ;
Schulman, G ;
Smith, W ;
Thornley-Brown, D ;
Tisher, CC ;
Toto, RD ;
Wright, JT ;
Xu, SC .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (21) :2719-2728
[2]   THERAPEUTIC ADVANTAGE OF CONVERTING ENZYME-INHIBITORS IN ARRESTING PROGRESSIVE RENAL-DISEASE ASSOCIATED WITH SYSTEMIC HYPERTENSION IN THE RAT [J].
ANDERSON, S ;
RENNKE, HG ;
BRENNER, BM .
JOURNAL OF CLINICAL INVESTIGATION, 1986, 77 (06) :1993-2000
[3]   Retarding the progression of renal disease [J].
Brenner, BM .
KIDNEY INTERNATIONAL, 2003, 64 (01) :370-378
[4]   Regional variation in the incidence of end-stage renal disease in Indigenous Australians [J].
Cass, A ;
Cunningham, J ;
Wang, ZQ ;
Hoy, W .
MEDICAL JOURNAL OF AUSTRALIA, 2001, 175 (01) :24-27
[5]  
CHAPMAN AB, 1994, J AM SOC NEPHROL, V5, P1349
[6]   Diuretics versus angiotensin-converting enzyme inhibitors in autosomal dominant polycystic kidney disease [J].
Ecder, T ;
Edelstein, CL ;
Fick-Brosnahan, GM ;
Johnson, AM ;
Chapman, AB ;
Gabow, PA ;
Schrier, RW .
AMERICAN JOURNAL OF NEPHROLOGY, 2001, 21 (02) :98-103
[7]   Effect of antihypertensive therapy on renal function and urinary albumin excretion in hypertensive patients with autosomal dominant polycystic kidney disease [J].
Ecder, T ;
Chapman, AB ;
Brosnahan, GM ;
Edelstein, CL ;
Johnson, AM ;
Schrier, RW .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2000, 35 (03) :427-432
[8]   END-STAGE RENAL-DISEASE IN US MINORITY-GROUPS [J].
FELDMAN, HI ;
KLAG, MJ ;
CHIAPELLA, AP ;
WHELTON, PK .
AMERICAN JOURNAL OF KIDNEY DISEASES, 1992, 19 (05) :397-410
[9]  
FOXMAN B, 1991, J AM SOC NEPHROL, V2, P1144
[10]   Racial differences in the progression from chronic renal insufficiency to end-stage renal disease in the United States [J].
Hsu, CY ;
Lin, F ;
Vittinghoff, E ;
Shlipak, MG .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2003, 14 (11) :2902-2907