title: Slower decline of glomerular filtration rate in the Japanese general population: a longitudinal 10-year follow-up study.
abstract: The prevalence of stage 3 to 5 chronic kidney disease (CKD) in Japan (18.7%) is considerably higher than that in the United States (4.5%). This study investigated in the Japanese general population whether this higher prevalence of CKD might reflect to a progressive decline of renal function, and in turn to the increased risk of end-stage renal disease. A decline in renal function over 10 years was examined in 120,727 individuals aged 40 years or older who participated in the annual health examination program of the two periods over 10 years, 1988-1993 and 1998-2003. Renal function was assessed with estimated glomerular filtration rate (GFR) using the abbreviated Modification of Diet in Renal Disease (MDRD) Study equation modified by a Japanese coefficient. The rate of GFR decline in the participants was 0.36 mL/min/1.73 m2/year on average. In the male population aged 50-79, the mean rate of GFR decline was significantly higher in the presence of hypertension than in its absence. The rate of GFR decline was more than two times higher in participants with proteinuria than in those without proteinuria in both sexes. The rate was significantly higher in participants with an initial GFR<50 mL/min/1.73 m2 among the groups younger than age 70 and in participants with an initial GFR<40 mL/min/1.73 m2 in the group with age 70-79. Based on the slow rate of GFR decline, we concluded that the decline in renal function progresses slowly in the Japanese general population. Hypertension, proteinuria and lower GFR were found to be significant risk factors for a faster decline of GFR.
authors.affiliation: Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan. imai@medone.med.osaka-u.ac.jp
authors.forename: Enyu
authors.initials: E
authors.lastname: Imai
authors.forename: Masaru
authors.initials: M
authors.lastname: Horio
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yamagata
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Iseki
authors.forename: Shigeko
authors.initials: S
authors.lastname: Hara
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ura
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Makino
authors.forename: Akira
authors.initials: A
authors.lastname: Hishida
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsuo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D007564:Japan / Q000453:epidemiology; D007674:Kidney Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011507:Proteinuria / Q000150:complications / Q000503:physiopathology; D012307:Risk Factors