Associations of kidney tests at medical facilities and health checkups with incidence of end-stage kidney disease: a retrospective cohort study

Yoshimura, Ryuichi; Yamamoto, Ryohei; Shinzawa, Maki; Kataoka, Rie; Ahn, Mina; Ikeguchi, Nami; Wakida, Natsuki; Toki, H.; Moriyama, Toshiki

doi:10.1038/s41598-021-99971-w

Cited by 4 publications

(5 citation statements)

References 46 publications

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“…SHC participation rates had a significant impact on prefecture-specific SIRs and prevalence of CKD, suggesting that increasing SHC participation rates could potentially have a preventive effect on CKD and ESKD in the general population. This is in line with the Neyagawa Health checkups and Health care in Kokuho database (NHHK) study, which showed that men who did not attend health checkups and did not undergo a kidney test using dipstick urinalysis and/or serum creatinine measurement at medical facilities were at significantly higher risk of treated ESKD than those who attended checkups, especially among those aged ≥ 75 years [ 9 ]. Although SHCs focus on metabolic syndrome rather than CKD, preventing metabolic syndrome could reduce the likelihood of developing CKD and ESKD.…”

Section: Discussionsupporting

confidence: 78%

“…Although we assumed that the prefecture-specific prevalence of CKD among participants in NDB Open Data is the same as that of the entire population, this may not be the case. According to the NHHK study, men who did not attend health checkups were at significantly higher risk of treated ESKD than those who attended checkups [ 9 ], suggesting that the prevalence of CKD among SHC participants would be lower than that among non-participants. If this is true, our calculations may have underestimated the prevalence of CKD and this may explain why the path from the prevalence of CKD to prefecture-specific SIRs was not significant.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, since this was an ecological study, there is a risk of ecological fallacy, i.e., findings observed at the prefecture level may not be seen at the individual level. However, the NHHK study showed that not attending health checkups was associated with an increased risk of ESKD even at the individual level [ 9 ], suggesting that increasing SHC participation rates is important for preventing ESKD at both the individual and prefecture levels.…”

Section: Discussionmentioning

confidence: 99%

“…One residual factor that may affect the variance in SIRs may be participation rates for health checkups. A cohort study of Japanese adults reported that not attending health checkups was associated with an increased risk of treated ESKD, defined as the initiation of kidney replacement therapy with hemodialysis, peritoneal dialysis, or kidney transplantation [ 9 ]. Thus, prefectures with low participation rates for health checkups may have an increased incidence of treated ESKD.…”

Section: Introductionmentioning

confidence: 99%

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Higher participation rates for specific health checkups are associated with a lower incidence of treated ESKD in Japan

Wakasugi,

Narita

2023

Clin Exp Nephrol

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Background A Japanese cohort study previously reported that not attending health checkups was associated with an increased risk of treated end-stage kidney disease (ESKD). The present study aimed to examine this association at the prefecture level. Methods We conducted an ecological study of all prefectures in Japan (n = 47) using five sources of nationwide open data. We explored associations of participation rates for Specific Health Checkups (SHC participation rates), the estimated prevalence of chronic kidney disease (CKD), and the ratio of nephrology specialists for each prefecture with prefecture-specific standardized incidence rates (SIRs) of treated ESKD using structural equation modeling. Results Prefecture-specific SHC participation rates ranged from 44.2% to 65.9%, and were negatively correlated with prefecture-specific SIRs and prevalence of CKD, and positively correlated with the ratio of nephrology specialists. SHC participation rates had significant negative effects on prefecture-specific SIRs (standardized estimate (β) = − 0.38, p = 0.01) and prefecture-specific prevalence of CKD (β = − 0.32, p = 0.02). Through SHC participation rates, the ratio of nephrology specialists had a significant indirect negative effect on prefecture-specific SIRs (β= − 0.14, p = 0.02). The model fitted the data well and explained 14% of the variance in SIRs. Conclusions Our findings support the importance of increasing SHC participation rates at the population level and may encourage people to undergo health checkups.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Higher participation rates for specific health checkups are associated with a lower incidence of treated ESKD in Japan

Wakasugi,

Narita

2023

Clin Exp Nephrol

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“…However, at our hospital, the frequency of dipstick test performance was not optimal, and that of quantitative tests was even lower (Table 3). Dipstick proteinuria is an essential item for annual health checkups provided collectively by insurers/municipalities or privately in Japan [4,36]. Thus, if we have access to the history of these checkup programs, hospital testing is unnecessary-but for now, this is not possible.…”

Section: Discussionmentioning

confidence: 99%

Chronic Kidney Disease Patients Visiting Various Hospital Departments: An Analysis in a Hospital in Central Tokyo, Japan

Fukui

Takeshita

Nakashima

et al. 2022

JPM

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To further improve care for chronic kidney disease (CKD) patients, healthcare providers’ awareness of CKD must be raised. Proteinuria testing is essential for CKD care, and collaboration with specialists is recommended for advanced cases. We reviewed data from the electronic medical records of outpatients at our hospital to analyze the clinical departments visited by CKD patients, and the frequency of proteinuria testing and referrals to nephrologists. We defined CKD as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or a urine protein concentration (U-pro) ≥ +1. We found that 31.1% of the CKD tests in September 2021 were performed in clinical departments other than internal medicine. Furthermore, within 1 year, 68.0% of CKD patients identified in September 2020 underwent a urine dipstick test, and 33.7% underwent a quantitative test for urinary protein or albumin. Additionally, 27.5% of individuals with an eGFR < 30 mL/min/1.73 m2 or U-pro ≥ +1 identified by non-nephrology departments in September 2020 visited the nephrology department within 1 year. Repeated assessments of these quality indicators may be useful for progress management in improving CKD care. Because CKD patients visited various departments in our hospital, campaigns to raise CKD awareness must reach a wide range of healthcare providers in hospitals.

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Renal pathology in adult and paediatric population of Japan: review of the Japan renal biopsy registry database from 2007 to 2017

Goto,

Imaizumi,

Hamada

et al. 2023

J Nephrol

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Background The Japan Renal Biopsy Registry (J-RBR), a nationwide, web-based, registry system, started in 2007. This study aimed to summarise the epidemiology of biopsy-diagnosed kidney disease in Japan over 10 years. Methods We analysed the J-RBR database, from 2007 to 2017. Patients’ clinical data collected at the time of biopsy and histopathological diagnoses were used for epidemiological and clinicopathologic analyses. Results The predominant renal biopsy diagnoses were immunoglobulin A nephropathy (39.2%), lupus nephritis (6.5%) and minimal change disease (6.0%) in younger adults (19–64 years), and membranous nephropathy (17.4%), antineutrophil cytoplasmic antibody-associated vasculitis or anti-glomerular basement membrane glomerulonephritis (13.0%), and immunoglobulin A nephropathy (12.5%) in older adults (≥ 65 years). The percentages of patients diagnosed with membranoproliferative glomerulonephritis and immunoglobulin A nephropathy decreased, whereas those with immunoglobulin A vasculitis and diabetic nephropathy increased over the decade. In paediatric patients (< 19 years), immunoglobulin A nephropathy (36.1%), minimal change disease (17.6%), and immunoglobulin A vasculitis (8.6%) were the predominant diagnoses. The percentage of patients diagnosed with immunoglobulin A vasculitis increased over the decade. Based on the sex distribution, minimal change disease and membranous nephropathy were predominant in men aged < 20 and > 40 years, respectively, whereas immunoglobulin A vasculitis and antineutrophil cytoplasmic antibody-associated vasculitis or anti-glomerular basement membrane glomerulonephritis were predominant in women in their 20s and 30s and aged < 50 years, respectively. Immunoglobulin A nephropathy was predominant in men at most ages and in women in their 20s to 40s. Conclusions This study describes the distribution and changes in kidney biopsy diagnoses over 10 years in Japan and paves the way for future research on kidney diseases in adults and children. Graphical abstract

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Associations of kidney tests at medical facilities and health checkups with incidence of end-stage kidney disease: a retrospective cohort study

Cited by 4 publications

References 46 publications

Higher participation rates for specific health checkups are associated with a lower incidence of treated ESKD in Japan

Higher participation rates for specific health checkups are associated with a lower incidence of treated ESKD in Japan

Chronic Kidney Disease Patients Visiting Various Hospital Departments: An Analysis in a Hospital in Central Tokyo, Japan

Renal pathology in adult and paediatric population of Japan: review of the Japan renal biopsy registry database from 2007 to 2017

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