Kakio Yuki, Uchida Haruhito A, Takeuchi Hidemi, Okuyama Yuka, Umebayashi Ryoko, Watatani Hiroyuki, Maeshima Yohei, Sugiyama Hitoshi, Wada Jun
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Int J Nephrol Renovasc Dis. 2019 Jul 1;12:143-152. doi: 10.2147/IJNRD.S198781. eCollection 2019.
From 2011, Okayama municipal government started the health checkup follow-up project to find those who were unaware of suffering chronic kidney disease and to prevent from aggravation of CKD stage. In this study, we aimed to evaluate the effect of 2 years' CKD-follow-up project regarding renal function and CKD risks.
Those who received a health checkup by the national health insurance in Okayama city in 2011 were recruited. The patients with lifestyle-related diseases or metabolic syndrome were excluded. Subjects who had an estimated glomerular filtration rate<50 mL/min/1.73 m or urinary protein positive by dipstick test were defined as compromised renal function group. They were recommended to visit a medical institution. Non-compromised renal function participants with two or more risks for CKD (hyperglycemia, higher blood pressure, dyslipidemia, hyperuricemia) were recommended to receive a health guidance (risk group). The change of renal function and CKD risks between 2011 and 2013 in each group was examined.
A total of 28,309 people received a health checkup in 2011. In compromised renal function group, 39.5% (96/243) of the subjects improved their CKD stages in 2013 regardless of the visit of medical institutions or the frequency of receiving health checkup. In risk group, 63.4% (260/410) of the subjects decreased their CKD risks in 2013 independent of the reception of health guidance.
In both compromised renal function group and risk group, more than half of subjects kept their kidney function (217/243) and decreased the number of CKD risks (260/410) in 2 years' follow-up. Receiving a health checkup itself and notification of one's own health condition could exert a protective effect on kidney function.
从2011年开始,冈山市政府启动了健康检查随访项目,以发现那些未意识到自己患有慢性肾病的人,并防止慢性肾病病情加重。在本研究中,我们旨在评估为期2年的慢性肾病随访项目对肾功能和慢性肾病风险的影响。
招募2011年在冈山市接受国民健康保险健康检查的人员。排除患有生活方式相关疾病或代谢综合征的患者。估算肾小球滤过率<50 mL/min/1.73 m²或尿试纸检测尿蛋白呈阳性的受试者被定义为肾功能受损组。建议他们前往医疗机构就诊。具有两种或更多慢性肾病风险(高血糖、高血压、血脂异常、高尿酸血症)的肾功能未受损参与者被建议接受健康指导(风险组)。检查了每组在2011年至2013年期间肾功能和慢性肾病风险的变化。
2011年共有28309人接受了健康检查。在肾功能受损组中,无论是否前往医疗机构就诊或接受健康检查的频率如何,39.5%(96/243)的受试者在2013年改善了慢性肾病分期。在风险组中,63.4%(260/410)的受试者在2013年降低了慢性肾病风险,与是否接受健康指导无关。
在肾功能受损组和风险组中,超过一半的受试者在2年的随访中保持了肾功能(217/243)并降低了慢性肾病风险数量(260/410)。接受健康检查本身以及了解自己的健康状况可能对肾功能产生保护作用。