Department of Public Health, Dokkyo Medical University, Mibu, Japan; Ibaraki Health Plaza, Ibaraki Health Service Association, Mito, Japan.
Department of Public Health, Dokkyo Medical University, Mibu, Japan; Ibaraki Health Plaza, Ibaraki Health Service Association, Mito, Japan.
Am J Kidney Dis. 2018 Jun;71(6):842-850. doi: 10.1053/j.ajkd.2017.09.013. Epub 2017 Dec 1.
Chronic kidney disease (CKD) is an important health problem for which risk equations have been developed for Western populations. This study aimed to develop and validate a risk prediction equation for CKD in a Japanese population.
Observational cohort study.
SETTING & PARTICIPANTS: The study included 135,007 participants who completed an annual health checkup in 1993 to 1996 in the Ibaraki Prefecture in Japan. Participants were initially free of CKD (defined as stage 3, 4, or 5 CKD or proteinuria [2+ or 3+] by dipstick). Follow-up information was available from health checkups 10 years after the initial evaluation. We used data from 40,963 women and 17,892 men in the northern region of the prefecture for the development of risk prediction equations and 53,042 women and 23,110 men in the southern region for external validation.
Age, estimated glomerular filtration rate (eGFR), body mass index, proteinuria, hematuria, hypertension, diabetes mellitus, smoking, and drinking.
Occurrence of CKD (defined as eGFR<60mL/min/1.73m and/or proteinuria [2+ or 3+] by dipstick).
Logistic regression analysis to estimate risk for CKD stratified by sex.
During follow-up, 7,500 cases of CKD developed in the northern region and 8,964, in the southern region. Older age, proteinuria (1+), higher systolic blood pressure, medication for hypertension, and current smoking were associated with increased risk for CKD in both sexes, whereas higher eGFR and daily alcohol intake were associated with lower risk. C statistics of risk estimation equations for CKD at 10 years were >0.8 for both the development and external validation populations, and discrimination of the risk estimation was fairly good in women and men.
Fluctuations in variables were not evaluated because the study used annual health checkups. This study excluded a large number of people for whom a 10-year health checkup was not available.
Estimations of risk for CKD after 10 years of follow-up in a general Japanese population can be achieved with a high level of validity.
慢性肾脏病（CKD）是一个重要的健康问题，已经为西方人群开发了风险方程。本研究旨在为日本人群开发和验证 CKD 的风险预测方程。
观察性队列研究。
该研究纳入了 1993 年至 1996 年期间在日本茨城县完成年度健康检查的 135007 名参与者。参与者最初没有 CKD（定义为 3、4 或 5 期 CKD 或蛋白尿[2+或 3+]）。从初始评估后 10 年的健康检查中获得随访信息。我们使用了该县北部地区 40963 名女性和 17892 名男性的数据来开发风险预测方程，并使用该县南部地区的 53042 名女性和 23110 名男性进行外部验证。
年龄、估算肾小球滤过率（eGFR）、体重指数、蛋白尿、血尿、高血压、糖尿病、吸烟和饮酒。
CKD 的发生（定义为 eGFR<60mL/min/1.73m 和/或蛋白尿[2+或 3+]）。
性别分层的 logistic 回归分析估计 CKD 的风险。
在随访期间，北部地区有 7500 例 CKD 病例，南部地区有 8964 例。在两性中，年龄较大、蛋白尿（1+）、较高的收缩压、高血压药物治疗和当前吸烟与 CKD 风险增加相关，而较高的 eGFR 和每日饮酒与较低的风险相关。CKD 风险评估方程在开发和外部验证人群中的 10 年 C 统计量均>0.8，并且在女性和男性中的风险评估区分度都相当好。
由于研究使用了年度健康检查，因此无法评估变量的波动情况。本研究排除了大量没有 10 年健康检查的人。
在一般日本人群中，10 年随访后 CKD 的风险估计可以达到较高的有效性。
