Abstract
The prevalence of stage 3 to 5 chronic kidney disease (CKD) in Japan (18.7%) is considerably higher than that in the United States (4.5%). This study investigated in the Japanese general population whether this higher prevalence of CKD might reflect to a progressive decline of renal function, and in turn to the increased risk of end-stage renal disease. A decline in renal function over 10 years was examined in 120,727 individuals aged 40 years or older who participated in the annual health examination program of the two periods over 10 years, 1988–1993 and 1998–2003. Renal function was assessed with estimated glomerular filtration rate (GFR) using the abbreviated Modification of Diet in Renal Disease (MDRD) Study equation modified by a Japanese coefficient. The rate of GFR decline in the participants was 0.36 mL/min/1.73 m2/year on average. In the male population aged 50–79, the mean rate of GFR decline was significantly higher in the presence of hypertension than in its absence. The rate of GFR decline was more than two times higher in participants with proteinuria than in those without proteinuria in both sexes. The rate was significantly higher in participants with an initial GFR <50 mL/min/1.73 m2 among the groups younger than age 70 and in participants with an initial GFR <40 mL/min/1.73 m2 in the group with age 70–79. Based on the slow rate of GFR decline, we concluded that the decline in renal function progresses slowly in the Japanese general population. Hypertension, proteinuria and lower GFR were found to be significant risk factors for a faster decline of GFR.
Similar content being viewed by others
Article PDF
References
Japanese Society for Dialysis Therapy : An Overview of Regular Dialysis Treatment in Japan as of Dec. 31, 2005. Tokyo, Japanese Society of Dialysis Therapy, 2006, 39 pp.
Imai E, Horio M, Nitta K, et al: Estimation of glomerular filtration rate by the MDRD equation modified for Japanese patients with chronic kidney disease. Clin Exp Nephrol 2007; 11: 41–50.
Imai E, Horio M, Iseki K, et al: Prevalence of chronic kidney disease (CKD) in Japanese population predicted by MDRD equation modified by a Japanese coefficient. Clin Exp Nephrol 2007; 11: 156–163.
Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS : Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2003; 41: 1–12.
Hallan S, Coresh J, Astor B, et al: International comparison of the relationship of chronic kidney disease prevalence and ESRD risk. J Am Soc Nephrol 2006; 17: 2275–2284.
Eriksen B, Ingebretsen O : The progression of chronic kidney disease: a 10-year population-based study of the effects of gender and age. Kidney Int 2006; 69: 375–382.
Lindeman R, Tobin J, Shock N : Longitudinal studies on the rate decline in renal function with age. J Am Geriatr Soc 1985; 33: 278–285.
Iseki K, Iseki C, Ikeyama Y, Kinjo K, Takishita S : Risk nof developing low glomerular filtration rate or elevated serum creatinine in s screened cohort in Okinawa, Japan. Hypertens Res 2007; 30: 167–174.
Epstein M : Aging and kidney. Physician 1985; 31: 123.
Hemmelgarn B, Zhang J, Manns B, et al: Progression of kidney dysfunction in the community-dwelling elderly. Kidney Int 2006; 69: 2155–2161.
Klahr S, Levey A, Beck G, et al: The effect of dietary protein restriction and blood-pressure control on the progression of chronic renal failure. N Engl J Med 1994; 330: 877–884.
Ishani A, Grandits G, Grimm R, et al: Association of single measurements of dipstick proteinuria, estimated glomerular filtration rate, and hematocrit with 25-year incidence of end-stage renal disease in the multiple risk factor intervention trial. J Am Soc Nephrol 2006; 17: 1444–1452.
Klag M, Whelton P, Randall B : Blood pressure and end-stage renal disease in men. N Engl J Med 1996; 334: 13–18.
Tozawa M, Iseki K, Iseki C, Kinjo K, Ikeyama Y, Takishita S : Blood pressure predicts risk of developing end-stage renal disease in men and women. Hypertension 2003; 41: 1341–1345.
Yamagata K, Ishida K, Sairenchi T, et al: Risk factors for chronic kidney disease in a community-based population: a 10-year follow-up study. Kidney Int 2007; 71: 159–166.
Vupputuri S, Francis M, Eberhardt M, et al: Effect of blood pressure on early decline in kidney function among hypertensive men. Hypertension 2003; 42: 1144–1149.
Fliser D, Franek E, Joest M, Block S, Mutschler E, Ritz E : Renal function in the elderly: impact of hypertension and cardiac function. Kidney Int 1997; 51: 1196–1204.
Naugarten J, Acharya A, Silbiger SR : Effect of gender on the progression of nondiabetic renal disease: a meta-analysis. J Am Soc Nephrol 2000; 11: 319–329.
Homma S, Hirose N, Ishida H, Ishii T, Araki G : Carotid plaque and intima-media thickness assessed by b-mode ultrasonography in subjects ranging from young adults to centenarians. Stroke 2001; 32: 830–835.
Shoji T, Emoto M, Tabata T, et al: Advanced atherosclerosis in predialysis patients with chronic renal failure. Kidney Int 2002; 61: 2187–2192.
Jones C, Francis M, Eberhardt M, et al: Microalbuminuria in the US population: Third national hralth and nutrition examination survey. Am J Kidney Dis 2002; 39: 445–459.
Selby J, FitzSimmons S, Newman J, Katz P, Sepe S, Showstack J : The natural history and epidemiology of diabetic nephropathy. Implications for prevention and control. JAMA 1990; 263: 1954–1960.
Iseki K, Ikeyama Y, Iseki C, Takishita S : Proteinuria and the risk of developing end-stage renal disease. Kidney Int 2003; 63: 1468–1474.
Levey AS, Coresh J, Greene T, et al: Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 2006; 145: 247–254.
Imai E, Horio M, Nitta K, et al: Modification of the MDRD Study equation for Japan. Am J Kidney Dis 2007; 50: 927–937.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Imai, E., Horio, M., Yamagata, K. et al. Slower Decline of Glomerular Filtration Rate in the Japanese General Population: A Longitudinal 10-Year Follow-Up Study. Hypertens Res 31, 433–441 (2008). https://doi.org/10.1291/hypres.31.433
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1291/hypres.31.433
Keywords
This article is cited by
-
Population characteristics and diagnosis rate of chronic kidney disease by eGFR and proteinuria in Japanese clinical practice: an observational database study
Scientific Reports (2024)
-
Changes in estimated glomerular filtration rate in patients administered proton pump inhibitors: a single-center cohort study
Naunyn-Schmiedeberg's Archives of Pharmacology (2024)
-
Impact of moderate to vigorous intensity physical activity on change in renal function in patients after acute myocardial infarction
Heart and Vessels (2024)
-
Slope of the estimated glomerular filtration rate and its associated factors among individuals with chronic kidney disease in the general Japanese population
Clinical and Experimental Nephrology (2024)
-
Serum and plasma levels of Ba, but not those of soluble C5b-9, might be affected by renal function in chronic kidney disease patients
BMC Nephrology (2023)