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. 2020 Apr 10;5(5):694-705.
doi: 10.1016/j.ekir.2020.03.006. eCollection 2020 May.

Diagnosis Patterns of CKD and Anemia in the Japanese Population

Tomomi Kimura  1 , Robert Snijder  2 , Kazutoshi Nozaki  3
Affiliations

Diagnosis Patterns of CKD and Anemia in the Japanese Population

Tomomi Kimura et al. Kidney Int Rep. .

Erratum in

Abstract

Introduction: Although early intervention for chronic kidney disease (CKD) and renal anemia are desirable, these conditions are often asymptomatic during their early stages and may be underdiagnosed.

Methods: We retrospectively analyzed Japanese administrative claims data for general and hospital populations. The data period for the general and hospital data ranged from January 2011 to December 2016 and from April 2008 to July 2017, respectively. CKD stage was determined by estimated glomerular filtration rate (eGFR). Anemia was defined per Japanese guidelines using hemoglobin (Hb) values. The proportion of patients who had eGFR-defined stages G3-G5 CKD without a CKD diagnosis, and Hb-defined anemia without an anemia diagnosis or treatment records, was estimated.

Results: Among 16,779 (general) and 68,161 (hospital) patients, a high proportion of G3 CKD patients did not have a CKD-related diagnosis (general: G3a, 95.0%; G3b, 68.4%; hospital: G3a, 89.2%; G3b, 67.9%); however, some patients were treated with antihypertensives. Among anemic patients, 75.7% (G3a) and 66.7% (G3b) of the general population, and 56.2% (G3a) and 47.5% (G3b) of the hospital population, did not have an anemia-related diagnosis or treatment. CKD and anemia were more likely to be diagnosed in patients with G4 and G5 CKD.

Conclusion: A high proportion of G3 CKD patients did not have a CKD-related diagnosis. Likewise, many anemic patients with G3 CKD did not have an anemia-related diagnosis. Despite the lack of a CKD-related diagnosis, some patients received appropriate treatment (e.g., antihypertensives). Further outreach to CKD and anemia patients at earlier stages may be warranted.

Keywords: Japan; administrative database; anemia; chronic kidney disease; underdiagnosed; undiagnosed.

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Figures

Figure 1
Figure 1
Study design. Estimated glomerular filtration rate (eGFR)1 and eGFR2 are categorized as same chronic kidney disease (CKD) stage.
Figure 2
Figure 2
Flowchart of patients from the (a) hospital and (b) insurance claims databases. CKD, chronic kidney disease; Hb, hemoglobin.
Figure 3
Figure 3
Prevalence of chronic kidney disease (CKD) patients without CKD-related diagnosis code by (a,b) CKD stage and (c) specialty in the hospital population.
Figure 4
Figure 4
Distribution of hemoglobin (Hb) values by chronic kidney disease stage in the (a) general and (b) hospital populations.
Figure 5
Figure 5
Prevalence of anemia by chronic kidney disease stage and age in the (a) general and (b) hospital populations.
Figure 6
Figure 6
Prevalence of anemic patients without anemia-related diagnosis code or anemia-related treatment by (a,b) chronic kidney disease stage and (c) specialty in the hospital population. Treatment-required anemia defined as hemoglobin <11 g/dl.
Figure 7
Figure 7
Anemia treatment type by chronic kidney disease stage. (a) General population and (b) hospital population. ESA, erythropoiesis-stimulating agent; P binder, phosphate binder.
See this image and copyright information in PMC

References

    1. Nagata M., Ninomiya T., Doi Y. Trends in the prevalence of chronic kidney disease and its risk factors in a general Japanese population: the Hisayama Study. NephrolDial Transplant. 2010;25:2557–2564. - PubMed
    1. Imai E., Horio M., Watanabe T. Prevalence of chronic kidney disease in the Japanese general population. Clin Exp Nephrol. 2009;13:621–630. - PubMed
    1. Sato Y., Fujimoto S., Konta T. Anemia as a risk factor for all-cause mortality: obscure synergic effect of chronic kidney disease. Clin Exp Nephrol. 2018;22:388–394. - PubMed
    1. Iseki K., Kohagura K. Anemia as a risk factor for chronic kidney disease. Kidney Int Suppl. 2007;(107):S4–S9. - PubMed
    1. Tsuruya K., Hirakata H. Anemia as a risk factor for CKD and CVD. Nihon Rinsho. 2008;66:1786–1793. - PubMed