Distribution of and factors contributing to chronic kidney disease in a middle-aged working population.

Yuka Noborisaka,Masao Ishizaki,Yuichi Yamada,Hitoshi Yokoyama,Masaru Miyao,Ryumon Honda,Masaji Tabata

doi:10.1007/s12199-013-0343-9

Abstract

To clarify the distribution of chronic kidney disease (CKD) and the factors contributing to its development and progression in middle-aged Japanese workers/employees. This was a retrospective study involving 3,964 men and 2,698 women aged 35-64 years in 2009 who had been followed-up until 2003. Data on proteinuria determined with a dipstick and glomerular filtration rate estimated from serum creatinine concentration (eGFR) were collected in the annual health check-ups. Proteinuria was detected in 2.9 and 1.1 % of the men and women, respectively, and total CKD was detected in 16.0 and 16.1 % of the men and women respectively. Moderate or severe CKD associated a high risk of cardiovascular diseases and end-stage kidney disease was found mostly in the male subjects [2.0 (men) vs. 0.6 % (women)]. High-risk CKD was found in 3.3 % of the men aged 55-64 years. A body mass index (BMI) of ≥30, hypertension, diabetes mellitus (DM), current smoking and some job types were independently related to the development of proteinuria, while age, BMI, hypertriglyceridemia, and job types were related to total CKD. The development of high-risk CKD was related to preceding mild CKD signs of reduced eGFR and proteinuria as well as to hypertension, DM, smoking, and job type. Chronic kidney disease was found in 16 % of middle-aged workers with an equal prevalence in both sexes, while high-risk CKD was found mostly in men, of whom 3.3 % were aged 55-64 years. Obesity, hypertension, DM, smoking and some job types were related to the development and progression of CKD.

Highlights

The concept of chronic kidney disease (CKD) characterized by clinical signs of renal damage, such as proteinuria and/or reduced glomerular filtration rate (GFR), was advocated by the National Kidney Foundation in the USA in 2002 [1] and endorsed by an international organization of the Kidney Disease: Improving Global Outcomes (KDIGO) [2] in the belief that the development of renal failure [end-stage kidney disease (ESKD)] can be prevented or delayed by the early detection and treatment of CKD
A body mass index (BMI) of C30, hypertension, diabetes mellitus (DM), current smoking and some job types were independently related to the development of proteinuria, while age, BMI, hypertriglyceridemia, and job types were related to total CKD
Chronic kidney disease was found in 16 % of middle-aged workers with an equal prevalence in both sexes, while high-risk CKD was found mostly in men, of whom 3.3 % were aged 55–64 years

Summary

Introduction

The concept of chronic kidney disease (CKD) characterized by clinical signs of renal damage, such as proteinuria and/or reduced glomerular filtration rate (GFR), was advocated by the National Kidney Foundation in the USA in 2002 [1] and endorsed by an international organization of the Kidney Disease: Improving Global Outcomes (KDIGO) [2] in the belief that the development of renal failure [end-stage kidney disease (ESKD)] can be prevented or delayed by the early detection and treatment of CKD. In Japan, the number of CKD patients is estimated to be 13.3 million. The significance of CKD as a common health problem has been recognized with regard to its progression to ESKD and to the high occurrence of associated cardiovascular disease (CVD) [7]. Based on the strong association between proteinuria/albuminuria and the occurrence of CVD in CKD patients [8], KDIGO proposed new criteria of CKD severity in which great importance was attached to the presence of albuminuria [9], which presented a new paradigm of the significance of CKD as a public health issue. The Japanese version of the new criteria, mentioning proteinuria as well as albuminuria, was published by JSN in 2012 [6]. The impact of CKD on the health of working populations in Japan has not yet been well evaluated, in part because the measurement of serum creatinine (Cr) concentrations is not mandated in the health check-ups conducted in workplaces

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