TY - JOUR
T1 - Risk factors for CKD progression in Japanese patients
T2 - findings from the Chronic Kidney Disease Japan Cohort (CKD-JAC) study
AU - For The Chronic Kidney Disease Japan Cohort Study Group
AU - Inaguma, Daijo
AU - Imai, Enyu
AU - Takeuchi, Ayano
AU - Ohashi, Yasuo
AU - Watanabe, Tsuyoshi
AU - Nitta, Kosaku
AU - Akizawa, Tadao
AU - Matsuo, Seiichi
AU - Makino, Hirofumi
AU - Hishida, Akira
N1 - Publisher Copyright:
© 2016, The Author(s).
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Background: Chronic kidney disease (CKD) eventually progresses to end-stage renal disease (ESRD). However, risk factors associated with CKD progression have not been well characterized in Japanese patients with CKD who are less affected with coronary disease than Westerners. Methods: A large-scale, multicenter, prospective, cohort study was conducted in patients with CKD and under nephrology care, who met the eligibility criteria [Japanese; age 20–75 years; and estimated glomerular filtration rate (eGFR): 10–59 mL/min/1.73 m2]. The primary endpoint was a composite of time to a 50 % decline in eGFR from baseline or time to the initiation of renal replacement therapy (RRT). The secondary endpoints were the rate of decline in eGFR from baseline, time to a 50 % decline in eGFR from baseline, time to the initiation of RRT, and time to doubling of serum creatinine (Cre) concentration. Results: 2966 patients (female, 38.9 %; age, 60. 3 ± 11.6 years) were enrolled. The incidence of the primary endpoint increased significantly (P < 0.0001) in concert with CKD stage at baseline. The multivariate Cox proportional hazards models revealed that elevated systolic blood pressure (SBP) [hazard ratio (HR) 1.203, 95 % confidence interval (CI) 1.099–1.318)] and increased albumin-to-creatinine ratio (UACR ≥ 1000 mg/g Cre; HR: 4.523; 95 % CI 3.098–6.604) at baseline were significantly associated (P < 0.0001, respectively) with the primary endpoint. Conclusions: Elevated SBP and increased UACR were risk factors that were significantly associated with CKD progression to ESRD in Japanese patients under nephrology care. UMIN clinical trial registry number: UMIN000020038.
AB - Background: Chronic kidney disease (CKD) eventually progresses to end-stage renal disease (ESRD). However, risk factors associated with CKD progression have not been well characterized in Japanese patients with CKD who are less affected with coronary disease than Westerners. Methods: A large-scale, multicenter, prospective, cohort study was conducted in patients with CKD and under nephrology care, who met the eligibility criteria [Japanese; age 20–75 years; and estimated glomerular filtration rate (eGFR): 10–59 mL/min/1.73 m2]. The primary endpoint was a composite of time to a 50 % decline in eGFR from baseline or time to the initiation of renal replacement therapy (RRT). The secondary endpoints were the rate of decline in eGFR from baseline, time to a 50 % decline in eGFR from baseline, time to the initiation of RRT, and time to doubling of serum creatinine (Cre) concentration. Results: 2966 patients (female, 38.9 %; age, 60. 3 ± 11.6 years) were enrolled. The incidence of the primary endpoint increased significantly (P < 0.0001) in concert with CKD stage at baseline. The multivariate Cox proportional hazards models revealed that elevated systolic blood pressure (SBP) [hazard ratio (HR) 1.203, 95 % confidence interval (CI) 1.099–1.318)] and increased albumin-to-creatinine ratio (UACR ≥ 1000 mg/g Cre; HR: 4.523; 95 % CI 3.098–6.604) at baseline were significantly associated (P < 0.0001, respectively) with the primary endpoint. Conclusions: Elevated SBP and increased UACR were risk factors that were significantly associated with CKD progression to ESRD in Japanese patients under nephrology care. UMIN clinical trial registry number: UMIN000020038.
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U2 - 10.1007/s10157-016-1309-1
DO - 10.1007/s10157-016-1309-1
M3 - Article
C2 - 27412450
AN - SCOPUS:84978100599
SN - 1342-1751
VL - 21
SP - 446
EP - 456
JO - Clinical and Experimental Nephrology
JF - Clinical and Experimental Nephrology
IS - 3
ER -