Takahashi Susumu, Okada Kazuyoshi, Yanai Mitsuru
International Kidney Evaluation Association Japan, Tokyo, Japan.
Kidney Int Suppl. 2010 Mar(116):S17-23. doi: 10.1038/ki.2009.539.
The International Kidney Evaluation Association Japan evaluated chronic kidney disease (CKD) in Japan, using a Japanese version of the US National Kidney Foundation's Kidney Early Evaluation Program (KEEP). The screening criteria for the first 1065 participants were presence of diabetes or hypertension, or family history of diabetes, hypertension, or kidney disease. Mean age was 59.7+/-16.1 years; 501 participants were men, 564 women. Of participants, 26.9% had diabetes, 59.2% had hypertension (with an additional 21.5% diagnosed after the program), 16.9% had history of diabetes and hypertension together, and 30.6% had neither, but had family history of diabetes, hypertension, or kidney disease. CKD (stages 1-4) prevalence was 26.7%, defined by albumin-creatinine ratio and estimated glomerular filtration rate. CKD prevalence was 35.0% among diabetic participants, 34.8% among hypertensive participants, and 37.1% among participants with cardiovascular disease (CVD). The following baseline conditions were significantly associated with discovered CKD: diabetes, odds ratio 1.71 (95% confidence interval 1.28-2.30); hypertension, 3.42 (2.15-5.44); CVD, 1.88 (1.37-2.57). CKD prevalence was high compared with the general Japanese population. KEEP Japan seems to define a high-risk population with evidence of CKD based on the targeted nature of the program.
日本国际肾脏评估协会采用美国国家肾脏基金会肾脏早期评估项目(KEEP)的日语版本对日本的慢性肾脏病(CKD)进行了评估。前1065名参与者的筛查标准为患有糖尿病或高血压,或有糖尿病、高血压或肾脏疾病的家族史。平均年龄为59.7±16.1岁;501名参与者为男性,564名参与者为女性。参与者中,26.9%患有糖尿病,59.2%患有高血压(另有21.5%在该项目开展后被诊断出患有高血压),16.9%同时有糖尿病和高血压病史,30.6%既没有糖尿病也没有高血压,但有糖尿病、高血压或肾脏疾病的家族史。根据白蛋白 - 肌酐比值和估算肾小球滤过率定义,CKD(1 - 4期)患病率为26.7%。糖尿病参与者中的CKD患病率为35.0%,高血压参与者中的患病率为34.8%,心血管疾病(CVD)参与者中的患病率为37.1%。以下基线状况与所发现的CKD显著相关:糖尿病,比值比1.71(95%置信区间1.28 - 2.30);高血压,3.42(2.15 - 5.44);CVD,1.88(1.37 - 2.57)。与日本普通人群相比,CKD患病率较高。基于该项目的针对性,日本的KEEP似乎确定了一个有CKD证据的高危人群。