Satoh Hiroaki, Ohira Tetsuya, Nagai Masato, Hosoya Mitsuaki, Sakai Akira, Watanabe Tsuyoshi, Ohtsuru Akira, Kawasaki Yukihiko, Suzuki Hitoshi, Takahashi Atsushi, Kobashi Gen, Ozasa Kotaro, Yasumura Seiji, Yamashita Shunichi, Kamiya Kenji, Abe Masafumi
Department of Diabetology, Endocrinology, and Metabolism, Fukushima Medical University, Japan.
Intern Med. 2016;55(18):2563-9. doi: 10.2169/internalmedicine.55.7023. Epub 2016 Sep 15.
Objective We conducted the present study to evaluate the prevalence of chronic kidney disease (CKD) and CKD complications among evacuees and non-evacuees after the Great East Japan Earthquake and Fukushima Daiichi nuclear disaster. Methods Twenty-seven thousand and eighty-eight subjects who were living near the Fukushima Daiichi Nuclear Power Plant in Fukushima Prefecture in Japan, aged ≥40 years by the Heath Care Insures, were included in the analyses. Metabolic factors were compared between the evacuees and non-evacuees stratified by the eGFR and proteinuria grades. Results The prevalence of CKD with a low eGFR (<60 mL/min/1.73 m(2)) and proteinuria were 21.59% and 1.85%, respectively. The risk of CKD complications was classified into four grades according to the eGFR and proteinuria grades. The prevalence of diabetes, hypertension, and dyslipidemia were significantly higher in the very high risk group than in the low risk group. The prevalence of diabetes and dyslipidemia were significantly higher in evacuees than in non-evacuees in only the low risk group. However, a multivariate logistic regression analysis showed that evacuation was not significantly associated with the risk of a low eGFR or proteinuria. Conclusion This study did not reach the definitive conclusion that evacuation elevated the risk of CKD complication, although evacuation might lead to increased CKD complications in the future. We believe that this information is important for follow-up and lifestyle change recommendations for evacuees.
目的 我们开展本研究以评估东日本大地震及福岛第一核电站核灾难后撤离者和未撤离者中慢性肾脏病（CKD）及CKD并发症的患病率。方法 分析纳入了日本福岛县福岛第一核电站附近年龄≥40岁、参加医保的27088名受试者。比较了根据估算肾小球滤过率（eGFR）和蛋白尿分级分层的撤离者和未撤离者之间的代谢因素。结果 eGFR低（<60 mL/min/1.73 m²）的CKD患病率和蛋白尿患病率分别为21.59%和1.85%。根据eGFR和蛋白尿分级将CKD并发症风险分为四级。极高风险组中糖尿病、高血压和血脂异常的患病率显著高于低风险组。仅在低风险组中，撤离者的糖尿病和血脂异常患病率显著高于未撤离者。然而，多因素logistic回归分析显示，撤离与eGFR低或蛋白尿风险无显著关联。结论 本研究未得出撤离会增加CKD并发症风险的确切结论，尽管撤离未来可能导致CKD并发症增加。我们认为该信息对撤离者的随访及生活方式改变建议很重要。
