Skip to main content

Advertisement

Log in

Chronic Kidney Disease Japan Cohort study: baseline characteristics and factors associated with causative diseases and renal function

  • Original Article
  • Published:
Clinical and Experimental Nephrology Aims and scope Submit manuscript

An Erratum to this article was published on 06 October 2010

Abstract

Background

Prevalence of chronic kidney disease (CKD) is estimated to be 13.3 million in Japan, but patient characteristics during the predialysis period (CKD stages 3–5) are not well studied.

Methods

We established the Chronic Kidney Disease Japan Cohort (CKD-JAC) to study the incidence of cardiovascular disease (CVD), end-stage renal disease (ESRD), and all-cause mortality in predialysis patients treated by nephrologists for 4 years. The inclusion criteria were (1) Japanese and Asian patients living in Japan, (2) age 20–75 years, and (3) estimated glomerular filtration rate (eGFR) 10–59 ml/min/1.73 m2.

Results

We analyzed 2977 participants for baseline characteristics. Mean eGFR was 28.6 ± 11.8 ml/min/1.73 m2, and mean albuminuria was 976 ± 1340 mg/g Cr. In our study, 91.9% of participants had hypertension, but it was well controlled (131/76 mmHg). Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) were used by most participants. Less than 15% of participants had history of ischemic heart disease, and 11.5% had history of stroke. Heart failure and arteriosclerosis obliterans were present in 3.9% and 3.6% of patients, respectively. Indicators of arteriosclerosis, higher pulse wave velocity (PWV), and high pulse pressure were associated with diabetes and particularly with diabetic nephropathy. Patients included due to glomerulonephritis seemed to be at low risk for atherosclerosis and also to show lower levels of hypertension.

Conclusions

The difference between causative diseases is associated with different comorbidity and level of arteriosclerosis. Future analysis of the cohort will clarify whether incidence of ESRD and CVD differs among causative diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. USRDS. International comparison. Am J Kidney Dis. 2010;55(Suppl 1):S343–54.

    Google Scholar 

  2. Japanese Society of Dialysis Therapy. An overview of regular dialysis treatment in Japan as of Dec 31, 2008. 2009. http://docs.jsdt.or.jp/overview/. Accessed 1 March 2010.

  3. Imai E, Horio M, Watanabe T, Iseki K, Yamagata K, Hara S, et al. Prevalence of chronic kidney disease in the Japanese general population. Clin Exp Nephrol. 2009;13:621–30.

    Article  PubMed  Google Scholar 

  4. Sarnak M, Levey A, Schoolwerth A, Coresh J, Culleton B, Hamm LL, et al. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on kidney in cardiovascular disease, high blood pressure research, and epidemiology and prevention. Circulation. 2003;108:2154–69.

    Article  PubMed  Google Scholar 

  5. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305.

    Article  CAS  PubMed  Google Scholar 

  6. Blacher J, Asmar R, Djane S, London GM, Safar ME. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension. 1999;33:1111–7.

    CAS  PubMed  Google Scholar 

  7. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001;37:1236–41.

    CAS  PubMed  Google Scholar 

  8. Shoji T, Emoto M, Shinohara K, Kakiya R, Tsujimoto Y, Kishimoto H, et al. Diabetes mellitus, aortic stiffness, and cardiovascular mortality in end-stage renal disease. J Am Soc Nephrol. 2001;12:2117–24.

    CAS  PubMed  Google Scholar 

  9. Nakayama M, Metoki H, Terawaki H, Ohkubo T, Kikuya M, Sato T, et al. Kidney dysfunction as a risk factor for first symptomatic stroke events in a general Japanese population—the Ohasama study. Nephrol Dial Transplant. 2007;22:1910–5.

    Article  PubMed  Google Scholar 

  10. Lash JP, Go AS, Appel LJ, He J, Ojo A, Rahman M, et al. Chronic Renal Insufficiency Cohort (CRIC) Study: baseline characteristics and associations with kidney function. Clin J Am Soc Nephrol. 2009;4:1302–11.

    Article  PubMed  Google Scholar 

  11. Imai E, Matsuo S, Makino H, Watanabe T, Akizawa T, Nitta K, et al. Chronic Kidney Disease Japan Cohort (CKD-JAC) study: design and methods. Hypertens Res. 2008;3:1101–7.

    Article  Google Scholar 

  12. Miura K, Nakagawa H, Ohashi Y, Harada A, Taguri M, Kushiro T, et al. Four blood pressure indexes and the risk of stroke and myocardial infarction in Japanese men and women: a meta-analysis of 16 cohort studies. Circulation. 2009;119:1892–8.

    Article  PubMed  Google Scholar 

  13. Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.

    Article  CAS  PubMed  Google Scholar 

  14. McDowell SE, Coleman JJ, Ferner RE. Systemic review and meta-analysis of ethnic differences in risks of adverse reactions to drugs used in cardiovascular medicine. BMJ. 2006;332:1177–81.

    Article  CAS  PubMed  Google Scholar 

  15. McCullough PA, Li S, Jurkovitz CT, Stevens LA, Wang C, Collins AJ, et al. CKD and cardiovascular disease in screened high-risk volunteer and general populations: the Kidney Early Evaluation Program (KEEP) and National Health and Nutrition Examination Survey (NHANES) 1999–2004. Am J Kidney Dis. 2008;51(4 Suppl 2):S38–45.

    Article  PubMed  Google Scholar 

  16. Nakayama M, Sato T, Sato H, Yamaguchi Y, Takeuchi K, Obara K, Kurihara I, Sato K, Hotta O, Seino J, Miyata M, Takeuchi K, Otaka T, Nakayama K, Matsushima M, Otaka T, Kinoshita Y, Taguma Y, Ito S. Different clinical outcomes for cardiovascular events and mortality in chronic kidney disease according to underlying renal disease, Clin Exp Nephrol. 2010. doi:10.1007/s10157-010-0295-y.

  17. Kimoto E, Shoji T, Shinohara K, Hatsuda S, Mori K, Fukumoto S, et al. Regional arterial stiffness in patients with type 2 diabetes and chronic kidney disease. J Am Soc Nephrol. 2006;17:2245–52.

    Article  PubMed  Google Scholar 

  18. Wang MC, Tsai WC, Chen JY, Huang JJ. Stepwise increase in arterial stiffness corresponding with the stages of chronic kidney disease. Am J Kidney Dis. 2005;45:494–501.

    Article  PubMed  Google Scholar 

  19. Townsend RR, Wimmer NJ, Chirinos JA, Parsa A, Weir M, Perumal K, et al. Aortic PWV in chronic kidney disease: a CRIC ancillary study. Am J Hypertens. 2010;23:282–9.

    Article  PubMed  Google Scholar 

  20. DeLoach SS, Appel LJ, Chen J, Joffe MM, Gadegbeku CA, Mohler ER 3rd, et al. Aortic pulse pressure is associated with carotid IMT in chronic kidney disease: report from Chronic Renal Insufficiency Cohort. Am J Hypertens. 2009;22:1235–41.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Enyu Imai.

Additional information

For The CKD-JAC Study Group.

An erratum to this article can be found at http://dx.doi.org/10.1007/s10157-010-0352-6

Appendix

Appendix

This study was conducted by principal investigators at the following medical centers:

Yoshio Taguma, Sendai Social Insurance Hospital (Miyagi); Yoshitaka Maeda, Toride Kyodo Hospital (Ibaragi); Eiji Kusano, Jichi Medical University (Tochigi); Kosaku Nitta, Tokyo Women’s Medical University Hospital (Tokyo); Yasuhiro Komatsu, St. Luke’s International Hospital (Tokyo); Tadao Akizawa, Showa University Hospital (Tokyo); Eriko Kinugasa, Showa University Yokohama Northern Hospital (Kanagawa); Ashio Yoshimura, Showa University Fujigaoka Hospital (Kanagawa); Hiroshige Ohashi, Gifu Prefectural General Medical Center (Gifu); Yuzo Watanabe, Kasugai Municipal Hospital (Aichi); Daijyo Inaguma, Kei Kurata, Tosei General Hospital (Aichi); Enyu Imai, Yoshitaka Isaka, Osaka University Hospital (Osaka); Yoshiharu Tsubakihara, Osaka General Medical Center (Osaka); Masahito Imanishi, Osaka City General Hospital (Osaka); Masaki Fukushima, Kurashiki Central Hospital (Okayama); Hideki Hirakata, Fukuoka Red Cross Hospital (Fukuoka); Kazuhito Takeda, Iizuka Hospital (Fukuoka).

Contributors

  1. 1.

    Steering Committee: Akira Hishida (Hamamatsu University), Seiichi Matsuo (Nagoya University), Tsuyoshi Watanabe (Fukushima Medical University), Yasuo Ohashi (the University of Tokyo), Hirofumi Makino (Okayama University), Tadao Akizawa (Showa University), Kosaku Nitta (Tokyo Women’s Medical University), Enyu Imai (Nagoya University).

  2. 2.

    Data Center: Public Health Research Foundation (Tokyo).

  3. 3.

    Independent Cardiac Function Evaluation Committee: Kyoichi Mizuno (Nippon Medical School Hospital), Hiroshi Nishimura (the University of Tokyo), Satoshi Iimuro (the University of Tokyo).

  4. 4.

    Biostatistics Adviser: Yasuo Ohashi (the University of Tokyo).

  5. 5.

    Medical Economics Adviser: Takashi Fukuda (the University of Tokyo).

  6. 6.

    Nutrition Evaluation Adviser: Satoshi Sasaki (the University of Tokyo).

  7. 7.

    International Adviser: Harold I. Feldman (University of Pennsylvania).

  8. 8.

    General Adviser: Kiyoshi Kurokawa (National Graduate Institute for Policy Study).

  9. 9.

    Sponsor: Kyowa-Hakko-Kirin Co. Ltd.

About this article

Cite this article

Imai, E., Matsuo, S., Makino, H. et al. Chronic Kidney Disease Japan Cohort study: baseline characteristics and factors associated with causative diseases and renal function. Clin Exp Nephrol 14, 558–570 (2010). https://doi.org/10.1007/s10157-010-0328-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10157-010-0328-6

Keywords

Navigation