Iseki Kunitoshi, Kohagura Kentaro, Sakima Atsushi, Iseki Chiho, Kinjo Kozen, Ikemiya Yoshiharu, Takishita Shuichi
Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan.
Hypertens Res. 2007 Jan;30(1):55-62. doi: 10.1291/hypres.30.55.
To compare the risk factor demographics and the prevalence of chronic kidney disease (CKD), we analyzed two databases from the 1993 (N=143,948) and 2003 (N=154,019) mass screenings in Okinawa, Japan (Okinawa General Health Maintenance Association registry). We estimated the glomerular filtration rate (GFR) using serum creatinine (SCr) levels. SCr was measured by the modified Jaffe method in 1993 and by enzyme assay in 2003; the relation between the two methods was: SCr (Jaffe) = 0.194 + 1.079 x SCr (enzyme). CKD prevalence was compared using the estimated GFR calculated by the abbreviated Modification of Diet in Renal Disease (MDRD) equation. SCr was measured in 66.2% (1993) and 69.8% (2003) of the total screenees. Proteinuria was present in 3.4% (1993) and 4.3% (2003) of the total screened population, respectively. The prevalence of CKD (GFR<60 ml/min/1.73 m(2)) was similar between the two databases, being 15.7% in 1993 and 15.1% in 2003. However, the demographics of the CKD risk factors changed during the study period. The mean level of systolic blood pressure decreased, whereas the prevalence of obesity and the mean levels of serum cholesterol and fasting plasma glucose increased. In 2003, the estimated prevalence of metabolic syndrome in the general population of Japan calculated using the modified National Cholesterol Education Program (NCEP) criteria was 19.1%. The prevalence of CKD was significantly associated with that of metabolic syndrome: the age- and sex-adjusted odds ratio was 1.332 (95% confidence interval [CI], 1.277-1.389; p<0.0001). In conclusion, the demographics of the participants of the general screenings in Okinawa, Japan differed between the 1993 and 2003 screenings, but the prevalence of CKD seemed to be similar, or at least did not increase substantially, between the two databases.
为比较慢性肾脏病（CKD）的风险因素人口统计学特征及患病率，我们分析了日本冲绳1993年（N = 143,948）和2003年（N = 154,019）大规模筛查的两个数据库（冲绳综合健康维护协会登记处）。我们使用血清肌酐（SCr）水平估算肾小球滤过率（GFR）。1993年采用改良Jaffe法测量SCr，2003年采用酶法；两种方法的关系为：SCr（Jaffe）= 0.194 + 1.079×SCr（酶法）。使用简化的肾脏病饮食改良（MDRD）方程计算的估算GFR来比较CKD患病率。在全部受检者中，1993年有66.2%、2003年有69.8%测量了SCr。蛋白尿分别在1993年全部受检人群的3.4%和2003年的4.3%中出现。两个数据库中CKD（GFR < 60 ml/min/1.73 m²）的患病率相似，1993年为15.7%，2003年为15.1%。然而，在研究期间CKD风险因素的人口统计学特征发生了变化。收缩压平均水平下降，而肥胖患病率以及血清胆固醇和空腹血糖平均水平上升。2003年，使用改良的美国国家胆固醇教育计划（NCEP）标准计算的日本普通人群代谢综合征估计患病率为19.1%。CKD患病率与代谢综合征患病率显著相关：年龄和性别调整后的优势比为1.332（95%置信区间[CI]，1.277 - 1.389；p < 0.0001）。总之，日本冲绳普通筛查参与者的人口统计学特征在1993年和2003年筛查之间有所不同，但两个数据库中CKD患病率似乎相似，或者至少没有大幅增加。
