Kobayashi Arisa, Hirano Keita, Okuda Tadahisa, Ikenoue Tatsuyoshi, Yokoo Takashi, Fukuma Shingo
Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto-Shi, Kyoto, 606-8057, Japan.
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Clin Exp Nephrol. 2025 Mar;29(3):276-282. doi: 10.1007/s10157-024-02570-y. Epub 2024 Oct 5.
In aging societies, the prevalence of chronic kidney disease (CKD) is expected to increase but may be underestimated because many asymptomatic patients remain undiagnosed. This study aimed to estimate the CKD prevalence among the general older population in Japan.
This cross-sectional study used health screening data from the Japan Health Insurance Association collected between April 2014 and March 2023. Data from older people aged 65-90 years who underwent renal function screening for estimated glomerular filtration rate (eGFR) and urine protein tests were analyzed. CKD was defined as eGFR < 60 mL/min/1.73 m or proteinuria ≥ 1 + . Inverse probability weighting was used to account for the selection bias. The variables used for weighting were age, sex, insurance status, and the number of previous screenings.
Among 2.98 million older individuals, 588,809 (19.7%) had undergone screening (median [IQR] age, 69.9 [67.9-76.2] years, 337,862 women [57.4%]). Regarding the weighted CKD prevalence, 25.3% of the individuals aged 65-90 years had CKD; 11.8% of those aged 65-75 years and 34.6% of those aged 75 years and over showed an increase in prevalence with age. Among the patients with CKD, over half exhibited mild renal dysfunction without proteinuria. Hypertension and diabetes were common comorbidities in older patients with CKD.
This cross-sectional study revealed that the weighted prevalence of CKD in the older population aged 65-90 years was high (one in four individuals), indicating that it increases with age. Further studies are required to examine the clinical significance of these findings.
在老龄化社会中，慢性肾脏病（CKD）的患病率预计会上升，但可能被低估，因为许多无症状患者仍未被诊断出来。本研究旨在估计日本普通老年人群中的CKD患病率。
这项横断面研究使用了日本健康保险协会在2014年4月至2023年3月期间收集的健康筛查数据。对65至90岁接受过估算肾小球滤过率（eGFR）和尿蛋白检测的肾功能筛查的老年人的数据进行了分析。CKD被定义为eGFR＜60 mL/min/1.73 m²或蛋白尿≥1+。采用逆概率加权法来解决选择偏倚问题。用于加权的变量包括年龄、性别、保险状况和既往筛查次数。
在298万老年人中，588,809人（19.7%）接受了筛查（年龄中位数[四分位间距]为69.9[67.9 - 76.2]岁，女性337,862人[57.4%]）。关于加权CKD患病率，65至90岁的人群中25.3%患有CKD；65至75岁的人群中11.8%患病，75岁及以上的人群中34.6%患病，患病率随年龄增加而上升。在CKD患者中，超过一半表现为无蛋白尿的轻度肾功能不全。高血压和糖尿病是老年CKD患者常见的合并症。
这项横断面研究显示，65至90岁老年人群中CKD的加权患病率很高（四分之一的人患病），表明其随年龄增加而上升。需要进一步研究来探讨这些发现的临床意义。
