Trends in the prevalence of chronic kidney disease and its risk factors in a general Japanese population: the Hisayama Study

Abstract

Background: Chronic kidney disease (CKD) is increasingly recognized as a leading public health issue. However, there are limited data assessing secular trends in the prevalence of CKD in general Asian communities.

Methods: We performed three repeated cross-sectional surveys of residents aged >or=40 years in 1974 [2118 subjects (participation rate, 81.2%)], 1988 [2741 subjects (80.9%)] and 2002 [3297 subjects (77.6%)] in a Japanese community. We compared the prevalence of CKD [one or both of proteinuria and estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2)] and potential risk factors among the three surveys.

Results: The prevalence of CKD increased significantly with time in men (13.8% [95% confidence interval (95% CI), 11.4-16.2%] in 1974, 15.9% [95% CI, 13.6-18.2%] in 1988 and 22.1% [95% CI, 19.6-24.6%] in 2002; P for trend < 0.001), but not in women (14.3% [95% CI, 12.2-16.4%], 12.6% [95% CI, 10.9-14.3%] and 15.3% [95% CI, 13.4-17.2%]; P for trend = 0.97). The frequencies of individuals with CKD Stages 3-5 (eGFR < 60 mL/min/1.73 m(2)) increased over the three decades in both sexes. Despite the widespread use of antihypertensive agents, the proportions of individuals with CKD who reached blood pressure of <130/80 mmHg were only 27.0% in men and 47.5% in women. The frequency of metabolic disorders including diabetes, hypercholesterolaemia and obesity increased over the three decades in both sexes.

Conclusions: The prevalence of CKD increased significantly in men, but not in women over the last three decades in a general Japanese population. Our findings support the requirement for a comprehensive treatment for hypertension and metabolic disorders to reduce the burden of CKD.