Hattori Akiko, Imaizumi Takahiro, Toda Takuya, Sakurai Daisuke, Takai Nami, Miki Takahiro, Maekawa Michitaka, Kato Sawako, Hagiwara Yuta, Yoshida Yasuko, Maruyama Shoichi
Department of Nephrology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan.
Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan.
Clin Exp Nephrol. 2025 May;29(5):596-606. doi: 10.1007/s10157-024-02605-4. Epub 2024 Dec 16.
Chronic kidney disease (CKD) awareness could help prevent disease progression through modifiable risk factors. However, few patients with CKD are aware of their disease. We aimed to investigate the factors associated with CKD awareness and impact of CKD awareness on renal prognosis.
We investigated the proportion of participants with CKD who answered 'aware of CKD' in the questionnaire among those undergoing health check-ups from 2013 to 2022. Participants included working-age employees and their dependents covered by health insurance associations for large and medium-sized companies. The outcome was defined as the change from 'unaware' to 'aware' of CKD; multivariable logistic regression analysis assessed the association of urine tests or nutritional guidance with CKD awareness. A control group was randomly selected from the unaware group and matched for age, sex, estimated glomerular filtration rate (eGFR), urinary protein categories, and follow-up period. Changes in eGFR slopes before and after awareness were compared using linear mixed-effects models.
Of the 13,489 participants, 2.8% were aware of CKD at baseline; of the 1,614 with CKD-related disease codes, only 19.6% were aware. The odds ratios of urine tests or nutritional guidance in relation to awareness occurrence were 1.98 (1.29-3.05) and 3.01 (1.38-6.53), respectively. The difference in the eGFR slope improvement from before to after CKD awareness was + 0.92 mL/min/1.73 m per year (0.18-1.67; P = 0.015) in the aware group.
Our findings suggest that urine tests and nutritional guidance may promote CKD awareness, which may help slow its progression.
慢性肾脏病（CKD）知晓度有助于通过可改变的危险因素预防疾病进展。然而，很少有CKD患者知晓自己的病情。我们旨在调查与CKD知晓度相关的因素以及CKD知晓度对肾脏预后的影响。
我们调查了2013年至2022年接受健康检查的人群中，在问卷中回答“知晓CKD”的CKD参与者比例。参与者包括大中型公司健康保险协会覆盖的在职员工及其家属。结局定义为从“不知晓”CKD转变为“知晓”；多变量逻辑回归分析评估尿液检查或营养指导与CKD知晓度的关联。从未知晓组中随机选择一个对照组，并根据年龄、性别、估计肾小球滤过率（eGFR）、尿蛋白类别和随访期进行匹配。使用线性混合效应模型比较知晓前后eGFR斜率的变化。
在13489名参与者中，2.8%在基线时知晓CKD；在1614名有CKD相关疾病编码的参与者中，只有19.6%知晓。尿液检查或营养指导与知晓发生的比值比分别为1.98（1.29 - 3.05）和3.01（1.38 - 6.53）。在知晓组中，CKD知晓前后eGFR斜率改善的差异为每年 +0.92 mL/min/1.73m²（0.18 - 1.67；P = 0.015）。
我们的研究结果表明，尿液检查和营养指导可能会提高CKD知晓度，这可能有助于减缓其进展。
