Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Nephrol Dial Transplant. 2010 Aug;25(8):2557-64. doi: 10.1093/ndt/gfq062. Epub 2010 Feb 22.
Chronic kidney disease (CKD) is increasingly recognized as a leading public health issue. However, there are limited data assessing secular trends in the prevalence of CKD in general Asian communities.
We performed three repeated cross-sectional surveys of residents aged >or=40 years in 1974 [2118 subjects (participation rate, 81.2%)], 1988 [2741 subjects (80.9%)] and 2002 [3297 subjects (77.6%)] in a Japanese community. We compared the prevalence of CKD [one or both of proteinuria and estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2)] and potential risk factors among the three surveys.
The prevalence of CKD increased significantly with time in men (13.8% [95% confidence interval (95% CI), 11.4-16.2%] in 1974, 15.9% [95% CI, 13.6-18.2%] in 1988 and 22.1% [95% CI, 19.6-24.6%] in 2002; P for trend < 0.001), but not in women (14.3% [95% CI, 12.2-16.4%], 12.6% [95% CI, 10.9-14.3%] and 15.3% [95% CI, 13.4-17.2%]; P for trend = 0.97). The frequencies of individuals with CKD Stages 3-5 (eGFR < 60 mL/min/1.73 m(2)) increased over the three decades in both sexes. Despite the widespread use of antihypertensive agents, the proportions of individuals with CKD who reached blood pressure of <130/80 mmHg were only 27.0% in men and 47.5% in women. The frequency of metabolic disorders including diabetes, hypercholesterolaemia and obesity increased over the three decades in both sexes.
The prevalence of CKD increased significantly in men, but not in women over the last three decades in a general Japanese population. Our findings support the requirement for a comprehensive treatment for hypertension and metabolic disorders to reduce the burden of CKD.
慢性肾脏病（CKD）日益成为一个主要的公共卫生问题。然而，评估一般亚洲人群中 CKD 患病率的长期变化的数据有限。
我们对一个日本社区中年龄≥40 岁的居民进行了三次重复的横断面调查，分别在 1974 年（2118 名受试者[参与率，81.2%]）、1988 年（2741 名受试者[80.9%]）和 2002 年（3297 名受试者[77.6%]）进行。我们比较了三次调查中 CKD 的患病率（蛋白尿和估计肾小球滤过率[eGFR]＜60ml/min/1.73m2 中的一项或两项）和潜在的危险因素。
男性中 CKD 的患病率随时间显著增加（1974 年为 13.8%[95%置信区间（95%CI），11.4-16.2%]，1988 年为 15.9%[95%CI，13.6-18.2%]，2002 年为 22.1%[95%CI，19.6-24.6%]；趋势 P＜0.001），但女性中没有（14.3%[95%CI，12.2-16.4%]、12.6%[95%CI，10.9-14.3%]和 15.3%[95%CI，13.4-17.2%]；趋势 P=0.97）。在两性中，CKD 3-5 期（eGFR＜60ml/min/1.73m2）患者的比例在过去的 30 年中逐渐增加。尽管广泛使用了降压药物，但血压＜130/80mmHg 的 CKD 患者比例仅为男性的 27.0%和女性的 47.5%。在两性中，包括糖尿病、高胆固醇血症和肥胖症在内的代谢紊乱的频率在过去的 30 年中逐渐增加。
在一般日本人群中，过去 30 年来男性的 CKD 患病率显著增加，但女性没有增加。我们的研究结果支持需要对高血压和代谢紊乱进行综合治疗，以减轻 CKD 的负担。
