Prevalence, recognition and management of chronic kidney disease in Japan: population-based estimate using a healthcare database with routine health checkup data

Abstract

Background We aimed to update the prevalence of chronic kidney disease (CKD) in Japan. We also explored whether CKD was properly recognized and managed. Methods We used data of annual health checkup in 2017, compiling records of five million persons. This had laboratory results, and was linked to healthcare utilization record via personal identifier. CKD was defined as estimated glomerular filtration rate <60 mL/minute/1.73m2 at the checkup. This prevalence was compared with that in 2005 reported previously. Healthcare utilization, such as laboratory tests, disease coding and medication for comorbid diabetes (DM) and hypertension (HT), was used as an indicator for the recognition and management of CKD. Results Of the 761,565 records (median age: 46 years [interquartile range: 50-62 years]), CKD was found in 50,091 persons; the crude and age-adjusted prevalence was 63.1 and 71.8 per 1000 persons, respectively. The CKD prevalence was significantly higher in 2017 than in 2005, with a difference of 14.1 per 1000 persons. Among persons with CKD, >95% sought medical service and 64.6% received laboratory tests within 180 days of checkup. However, the diagnostic code suggestive of CKD was recorded in 23.2%, and prescriptions for DM and HT were found in 31.2% (1590/5096) and 36.7% (8081/22,019) of comorbid persons, respectively. Conclusions The prevalence of CKD in Japan may have increased over the past decade. However, the recognition of CKD was likely suboptimal, and there is room to improve the management of comorbid DM and HT.

A focus on CKD reporting and inappropriate prescribing among older patients discharged from geriatric and nephrology units throughout Italy: A nationwide multicenter retrospective cross-sectional study

“…Despite these efforts, the current relevant rate of CKD underdiagnosis is reported at the hospital level (Gentile et al, 2009;Tesfaye et al, 2019). Recent data from European (Bosi et al, 2021) and Japanese (Takeuchi et al, 2021) populations revealed that CKD was under-diagnosed in around 23%-25% of the study populations. Consistent with these previous findings, our study results confirmed that underreporting CKD was relatively common in hospitalized older patients, with up to 50.8% of CKD patients being reported as not having CKD at hospital discharge.…”

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

“…This is lower than the estimated prevalence of CKD that was previously reported in the general Japanese population [33], suggesting the presence of many latent, untested CKD patients [34]. There may also have been cases of CKD that were unrecognized despite testing [35].…”

Hepatic Steatosis Index and Chronic Kidney Disease among Middle-Aged Individuals: A Large-Scale Study in Japan

“…A previous study conducted in Japan showed that the prevalence among those aged 40-49 and 50-59 years was 4.0% and 7.5% in men, while the prevalence was 2.6% and 6.8% in women, respectively [28]. A recent study reported that the prevalence was 4.3% among men aged 40-49 years and 11.0% among those aged 50-59 years, while the prevalence was 3.1% among women aged 40-49 years and 10.0% among those aged 50-59 years [29]. The difference between our results and those of the other studies might be due to the difference in the data collection periods.…”