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. 2024 Mar;28(3):201-207.
doi: 10.1007/s10157-023-02412-3. Epub 2023 Oct 9.

Higher participation rates for specific health checkups are associated with a lower incidence of treated ESKD in Japan

Minako Wakasugi  1 , Ichiei Narita  2
Affiliations

Higher participation rates for specific health checkups are associated with a lower incidence of treated ESKD in Japan

Minako Wakasugi et al. Clin Exp Nephrol. 2024 Mar.

Abstract

Background: A Japanese cohort study previously reported that not attending health checkups was associated with an increased risk of treated end-stage kidney disease (ESKD). The present study aimed to examine this association at the prefecture level.

Methods: We conducted an ecological study of all prefectures in Japan (n = 47) using five sources of nationwide open data. We explored associations of participation rates for Specific Health Checkups (SHC participation rates), the estimated prevalence of chronic kidney disease (CKD), and the ratio of nephrology specialists for each prefecture with prefecture-specific standardized incidence rates (SIRs) of treated ESKD using structural equation modeling.

Results: Prefecture-specific SHC participation rates ranged from 44.2% to 65.9%, and were negatively correlated with prefecture-specific SIRs and prevalence of CKD, and positively correlated with the ratio of nephrology specialists. SHC participation rates had significant negative effects on prefecture-specific SIRs (standardized estimate (β) = - 0.38, p = 0.01) and prefecture-specific prevalence of CKD (β = - 0.32, p = 0.02). Through SHC participation rates, the ratio of nephrology specialists had a significant indirect negative effect on prefecture-specific SIRs (β= - 0.14, p = 0.02). The model fitted the data well and explained 14% of the variance in SIRs.

Conclusions: Our findings support the importance of increasing SHC participation rates at the population level and may encourage people to undergo health checkups.

Keywords: Dialysis; General population; Health checkups; Regional variation; Standardized incidence ratio.

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Conflict of interest statement

The authors declare that no conflict of interest exists.

Figures

Fig. 1
Fig. 1
SHC participation rates, SIRs of treated ESKD, prevalence of CKD, and ratio of nephrology specialists in the 47 prefectures. Prefecture-specific SIRs are presented in ascending order. Note that the y-axis in SIR for treated ESKD is a logarithmic scale. Dashed lines show national averages. CKD chronic kidney disease, ESKD end-stage kidney disease, SHC specific health checkups, SIR standardized incidence ratio
Fig. 2
Fig. 2
SEM models and standardized estimates. Solid lines indicate significant paths. Dashed lines indicate non-significant paths. The standardized regression coefficient is provided for each relationship. For simplicity, residual variance associated with independent variables is not represented. CKD chronic kidney disease, ESKD end-stage kidney disease, SEM structural equation modelling, SIR standardized incidence ratio
See this image and copyright information in PMC

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