SAT-249 Effect of Diabetes Mellitus on Incidence and Progression of Chronic Kidney Disease in General Japanese

Abstract

To study the effects of diabetes mellitus on incidence and progression of chronic kidney disease (CKD) in general population of Japanese. This is a retrospective cohort study using health checkup data in Iki City, Nagasaki Prefecture, Japan. The participants of the study included 5554 residents aged 40 years or older who attended health checkups twice or more over 8 years. This study consists of 2 sets of analyses: (1) the effects of diabetes mellitus on new-onset CKD (defined by an estimated glomerular filtration rate (eGFR) less than 60 mL/min or positive urinary protein) among 4571 subjects who did not have CKD at the initial health checkup, and (2) the effect of diabetes mellitus on progression of CKD (defined as exacerbation of the GFR category or the proteinuria category) in 983 subjects with CKD at the initial health checkup. Over a mean follow-up period of 4.6 years, 746 patients with new-onset CKD and 189 patients with CKD progression were confirmed. The incidence of CKD (per 1,000 person-years) in individuals with diabetes mellitus was 55.1%, which was higher than those without diabetes mellitus (33.9%). This correlation was significant (multivariate adjustment [hazard ratio (HR)] 1.44, 95% confidence interval [CI] 1.13-1.84) even after adjusting for the effects of other risk factors. The population attributable fraction was 3%. Similarly, the risk of CKD progression was also significantly higher in individuals with diabetes mellitus than in those without (HR 2.24, CI 1.57-3.19), and the population attributable fraction was 13%. Diabetes mellitus is a significant risk factor for both new-onset CKD and CKD progression in general population of Japanese. Approximately one-sixth of CKD progression was likely to be attributable to diabetes mellitus.