Risk factors for CKD progression in Japanese patients: findings from the Chronic Kidney Disease Japan Cohort (CKD-JAC) study

For The Chronic Kidney Disease Japan Cohort Study Group

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)446-456
Number of pages11
JournalClinical and Experimental Nephrology
Volume21
Issue number3
DOIs
Publication statusPublished - 01-06-2017

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Chronic Renal Insufficiency
Disease Progression
Japan
Cohort Studies
Glomerular Filtration Rate
Blood Pressure
Renal Replacement Therapy
Nephrology
Chronic Kidney Failure
Creatinine
Confidence Intervals
Proportional Hazards Models
Coronary Disease
Registries
Albumins
Clinical Trials
Prospective Studies
Incidence
Serum

All Science Journal Classification (ASJC) codes

  • Physiology
  • Nephrology
  • Physiology (medical)

Cite this

@article{6640581849e34ac8a7b9343a514b0e04,
title = "Risk factors for CKD progression in Japanese patients: findings from the Chronic Kidney Disease Japan Cohort (CKD-JAC) study",
abstract = "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.",
author = "{For The Chronic Kidney Disease Japan Cohort Study Group} and Daijo Inaguma and Enyu Imai and Ayano Takeuchi and Yasuo Ohashi and Tsuyoshi Watanabe and Kosaku Nitta and Tadao Akizawa and Seiichi Matsuo and Hirofumi Makino and Akira Hishida",
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Risk factors for CKD progression in Japanese patients : findings from the Chronic Kidney Disease Japan Cohort (CKD-JAC) study. / For The Chronic Kidney Disease Japan Cohort Study Group.

In: Clinical and Experimental Nephrology, Vol. 21, No. 3, 01.06.2017, p. 446-456.

Research output: Contribution to journalArticle

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

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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