Department of Nephrology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Ten-oudai, Tsukuba, Ibaraki, 305-8575, Japan.
Division of Nephrology and Hypertension, Department of Internal Medicine, Iwate Medical University School of Medicine, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan.
Clin Exp Nephrol. 2021 Aug;25(8):885-892. doi: 10.1007/s10157-021-02049-0. Epub 2021 Apr 10.
Most data on chronic kidney disease (CKD) prevalence has been based on single measurements of renal function and proteinuria. The aim was to determine the prevalence of CKD diagnosed by chronic proteinuria and/or reduced eGFR in a recent year in Japan.
In the main study, using a population-based cohort in Japan, the overall prevalence of CKD, defined as persistent positive proteinuria and/or eGFR < 60 ml/min/1.73 m, was determined. Of 2,849,557 persons, 763,104 had data for eGFR and proteinuria in both 2014 and 2015. For estimating number of CKD cases in Japanese adults, a regional cohort data with age ranging 22-87 years (N = 22,037) was further applied to the analysis.
Definitive CKD was present in 2.3-23.0% of men and 1.7-17.1% of women age from 40 to 74 years in the main cohort. The estimated prevalence of reduced eGFR and/or proteinuria in the baseline year alone was 15.7% in men and 13.6% in women; the prevalence of definitive CKD was 10.9% in men and 9.2% in women. The number of CKD cases based on a single-year test in Japanese adults over 20 years of age increased from 13.3 million to 14.8 million between 2005 and 2015.
Recent changes in prevalence of CKD seem to be mainly caused by an increase in Japan's elderly population. Although past reports may lead to overdiagnosis of CKD by a single-year test, the estimated number of definitive CKD was 10.2 million in 2015.
大多数关于慢性肾脏病（CKD）患病率的数据都是基于肾功能和蛋白尿的单次测量。本研究旨在确定在最近一年中，通过慢性蛋白尿和/或估算肾小球滤过率（eGFR）降低诊断为 CKD 的患病率。
在主要研究中，我们使用日本的一项基于人群的队列研究，确定了 CKD 的总体患病率，其定义为持续性蛋白尿阳性和/或 eGFR<60ml/min/1.73m。在 2849557 人中，有 763104 人在 2014 年和 2015 年均有 eGFR 和蛋白尿数据。为了估算日本成年人 CKD 病例数，进一步将年龄在 22-87 岁的区域队列数据（n=22037）应用于分析。
在主要队列中，40-74 岁男性和女性的 CKD 确诊率为 2.3%-23.0%，估计率为 15.7%和 13.6%；男性和女性的 eGFR 降低和/或蛋白尿的患病率为 10.9%和 9.2%。2005 年至 2015 年间，日本 20 岁以上成年人基于单次年度检测的 CKD 病例数从 1330 万增加到 1480 万。
最近 CKD 患病率的变化似乎主要是由于日本老年人口的增加所致。虽然过去的报告可能导致单次年度检测的 CKD 过度诊断，但 2015 年估计的确诊 CKD 病例数为 1020 万。
