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

BMC Nephrology

Sei Sasaki⁷  Shinichi Uchida⁷  Tatemitsu Rai⁷  Katsuki Kobayashi²  Takashi Kusaura^1,10  Masato Tajima^1,13  Rie Okutsu^1,17  Momono Yoshikawa^1,14  Seiji Inoshita⁸  Eiichiro Kanda⁵  Shigeaki Kimoto^1,12  Teiichi Tamura^1,15  Hiroyuki Tanaka^1,15  Yoshitaka Maeda⁶  Yasuhide Nishio^1,16  Ryoichi Ando⁴  Michio Kuwahara³  Yoshiko Chida¹  Takayuki Toda^1,11  Shotaro Naito⁹  Tomokazu Okado⁹  Yumi Noda⁹  Soichiro Iimori⁹ 

[1] Department of Nephrology, Nakano General Hospital, 4-59-16 Chuo, Chuo-ku, Tokyo 164-8607, Japan;Clinical Research Center, Chiba-East National Hospital, 673 Nitonacho, Chuo-ku, Chiba 260-8712, Japan;Department of Nephrology, Shuuwa General Hospital, 1200 Yahatashinden, Kasukabe-shi, Saitama 344-0035, Japan;Department of Nephrology, Musashino Red Cross Hospital, 1-26-1 Kyonancho, Musashino-shi, Tokyo 180-8610, Japan;Department of Nephrology, Tokyo Kyosai Hospital, 2-3-8 Nakameguro, Meguro-ku, Tokyo 153-8934, Japan;Department of Nephrology, JA Toride Medical Center, 2-1-1 Hongo, Toride-shi, Ibaraki 302-0022, Japan;Department of Nephrology, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8519, Japan;Department of Internal Medicine, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kohtohbashi, Sumida-ku, Tokyo 130-8575, Japan;Department of Chronic Kidney Disease, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8519, Japan;Department of Nephrology, Hiratsuka Kyosai Hospital, 9-11Oiwake, Hiratsuka-shi, Kanagawa 254-8502, Japan;Department of Nephrology, Tsuchiura Kyodo General Hospital, 11-7 Manabeshinmachi, Tsuchiura-shi, Ibaraki 300-0053, Japan;Department of Nephrology, Ome Municipal General Hospital, 4-16-5 Higashiome, Ome-shi, Tokyo 198-0042, Japan;Department of Nephrology, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, Japan;Department of Nephrology, Tokyo Metropolitan Otsuka Hospital, 2-8-1, Minamiotsuka, Toshima-ku, Tokyo 170-8476, Japan;Department of Nephrology, Yokosuka Kyosai Hospital, 1-16 Yonegahamadori, Yokosuka, Kanagawa 238-8558, Japan;Department of Nephrology, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8524, Japan;Department of Nephrology, Toshima Hospital, 33–1 Sakaecho, Itabashi-ku, Tokyo 173-0015, Japan

关键词: Nephrologist;    Cardiovascular disease;    Epidemiology;    Cohort study;    Chronic kidney disease;   

Others  :  1082887
DOI  :  10.1186/1471-2369-14-152

 received in 2012-12-12, accepted in 2013-07-11,  发布年份 2013

【 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.

【 授权许可】

   
2013 Iimori et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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