Undiagnosed and untreated chronic kidney disease and its impact on renal outcomes in the Japanese middle-aged general population
Autor: | Tatsuyoshi Ikenoue, Shingo Fukuma, Yoshiyuki Saito, Yukari Yamada |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty Epidemiology Population Health Behavior 030232 urology & nephrology Renal function Lower risk urologic and male genital diseases Undiagnosed Diseases 03 medical and health sciences 0302 clinical medicine Japan Risk Factors Internal medicine medicine Prevalence Humans 030212 general & internal medicine Longitudinal Studies Renal Insufficiency Chronic education Aged Aged 80 and over education.field_of_study Proteinuria business.industry Incidence (epidemiology) Public Health Environmental and Occupational Health Middle Aged medicine.disease Annual Screening female genital diseases and pregnancy complications Creatinine Disease Progression Female medicine.symptom business Kidney disease Glomerular Filtration Rate |
Zdroj: | Journal of epidemiology and community health. 73(12) |
ISSN: | 1470-2738 |
Popis: | BackgroundThe effectiveness of identifying and monitoring early-stage chronic kidney disease (CKD) is not fully recognised. This study quantified people with undiagnosed CKD among the middle-aged Japanese population and clarified potential risks of untreated CKD.MethodsWe included 71 233 individuals who underwent annual health check-ups (AHC) in 2014 for both baseline and follow-up proteinuria and serum creatine measurements. CKD was identified by AHC data as proteinuria or estimated glomerular filtration rate (eGFR) 2. We differentiated undiagnosed from diagnosed CKD using the medical claims database. In undiagnosed CKD, we assessed risk differences for disease progression, defined as an eGFR decline slope >3 mL/min/1.73 m2/year or proteinuria incidence over 3 years, between those who visited a physician for CKD treatment within 6 months after AHC and those who did not.ResultsCKD prevalence was 5.7% (5.2% undiagnosed and 0.5% diagnosed). Only 2.1% of the patients with undiagnosed CKD visited a physician for CKD treatment within 6 months after AHC. Between-group risk differences in instrumental variable adjustment models showed that those left untreated progressed to kidney diseases 16.3% more often than those who visited physicians for CKD treatment.ConclusionCKD was undiagnosed in 5.2% of the middle-aged general population. Only a few people visited physicians for CKD treatment. Visiting physicians for CKD treatment during the first 6 months after screening may be associated with a lower risk of kidney disease progression. |
Databáze: | OpenAIRE |
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