Ito Takafumi, Kamei Fumika, Sonoda Hirotaka, Oba Masafumi, Kawanishi Miharu, Yoshimura Ryuichi, Fukunaga Shohei, Egawa Masahiro
Division of Nephrology, Shimane University Hospital, 89-1 Enyacho, Izumo 693-8501, Shimane, Japan.
J Pers Med. 2021 Oct 28;11(11):1104. doi: 10.3390/jpm11111104.
To diagnose chronic kidney disease (CKD) at an early stage, it is important to promote appropriate health guidance and consultation recommendations through regular medical examinations and implementation of continuous high-quality and appropriate treatment. From fiscal year (FY) 2018, Izumo City has initiated the "Izumo City CKD Exacerbation Countermeasures" program. In this study, we aimed to report on the methods undertaken and the effects of this program. Residents aged 40-74 years who underwent specific health checkups from the Izumo City National Health Insurance in FY2018 and FY2019 were included. The rates of CKD re-examination candidates, re-examinations implementation, nephrologist referrals, and health guidance referrals between FY2018 and FY2019 were compared. The rate of CKD re-examination candidates in both years remained unchanged at approximately 7%. The rate of re-examination implementation in FY2019 significantly increased relative to that in FY2018 ( < 0.001). Subsequent re-examination candidate trends showed that the rate of nephrologist referrals did not increase. However, the rate of city health guidance referrals significantly increased ( < 0.001). Increase in the re-examination and health guidance examination rates indicate improved awareness of CKD among the public and family doctors, and it is expected to prevent CKD exacerbation in the future.
为了早期诊断慢性肾脏病（CKD），通过定期体检以及实施持续的高质量且适当的治疗来促进恰当的健康指导和咨询建议非常重要。从2018财年起，出云市启动了“出云市CKD病情恶化应对措施”项目。在本研究中，我们旨在报告该项目所采取的方法及其效果。纳入了在2018财年和2019财年接受出云市国民健康保险特定健康检查的40 - 74岁居民。比较了2018财年和2019财年之间CKD复查候选率、复查实施率、肾病科医生转诊率以及健康指导转诊率。两年的CKD复查候选率均保持在约7%不变。2019财年的复查实施率相对于2018财年显著增加（<0.001）。后续复查候选趋势显示，肾病科医生转诊率未增加。然而，市健康指导转诊率显著增加（<0.001）。复查和健康指导检查率的提高表明公众和家庭医生对CKD的认识有所提高，预计未来可预防CKD病情恶化。
