title: 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.
abstract: 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.
authors.affiliation: Department of Nephrology, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Iimori
authors.forename: Yumi
authors.initials: Y
authors.lastname: Noda
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Okado
authors.forename: Shotaro
authors.initials: S
authors.lastname: Naito
authors.forename: Takayuki
authors.initials: T
authors.lastname: Toda
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Chida
authors.forename: Michio
authors.initials: M
authors.lastname: Kuwahara
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Ando
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Nishio
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Maeda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Teiichi
authors.initials: T
authors.lastname: Tamura
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Kimoto
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Kanda
authors.forename: Seiji
authors.initials: S
authors.lastname: Inoshita
authors.forename: Momono
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: Rie
authors.initials: R
authors.lastname: Okutsu
authors.forename: Masato
authors.initials: M
authors.lastname: Tajima
authors.forename: Takashi
authors.initials: T
authors.lastname: Kusaura
authors.forename: Katsuki
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Tatemitsu
authors.initials: T
authors.lastname: Rai
authors.forename: Shinichi
authors.initials: S
authors.lastname: Uchida
authors.forename: Sei
authors.initials: S
authors.lastname: Sasaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D015995:Prevalence; D011446:Prospective Studies; D012017:Referral and Consultation; D006435:Renal Dialysis / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000628:therapy