1. Risk factors for chronic kidney disease progression over 20 years for primary prevention in Japanese individuals at a preventive medicine research center: Focus on the influence of plasma glucose levels.
- Author
-
Minami K, Sakuma Y, Ogawa K, Takemura K, Takahashi H, Inoue T, Suzuki Y, Takahashi H, Shimura H, Sato Y, Watanabe S, Yoshida S, Ogino J, and Hashimoto N
- Subjects
- Humans, Male, Female, Risk Factors, Middle Aged, Japan epidemiology, Primary Prevention methods, Aged, Adult, Preventive Medicine methods, Follow-Up Studies, East Asian People, Disease Progression, Renal Insufficiency, Chronic blood, Renal Insufficiency, Chronic epidemiology, Renal Insufficiency, Chronic prevention & control, Blood Glucose analysis, Glomerular Filtration Rate
- Abstract
Aims/introduction: Chronic kidney disease (CKD) is a very important issue globally because of the risk of its progressing to end-stage renal disease. We aimed to identify factors contributing to long-term estimated glomerular filtration rate (eGFR) decline to determine an early diagnosis and prevent CKD progression., Materials and Methods: From January 2003 to December 2006, 5,507 individuals underwent health checkups at our hospital's Preventive Medicine Research Center. We ultimately enrolled 2,175 individuals. The eGFR was ≥60 mL/min/1.73 m
2 at the start of observation period, which was 20 years. The event onset time was the day that the eGFR became <30 mL/min during the 20-year period. Baseline risk factors - in particular, the effect of plasma glucose levels on the eGFR - were extracted and evaluated by using Fine and Gray analysis., Results: During the 20-year observation, the hazard ratio (HR) of CKD progression was examined. A fasting plasma glucose (FPG) level ≥105 mg/dL was significantly associated with the risk of CKD progressing to an eGFR <30 mL/min. This trend was similar in the slope of eGFR. An FPG ≥105 mg/dL or an glycated hemoglobin level ≥6.5% was useful for intervening in CKD progression. Multivariate analysis showed that independent risk factors were an FPG level ≥105 mg/dL (HR 1.9; P < 0.001), age ≥60 years (HR 3.86; P < 0.001), obesity (HR 1.61; P < 0.01) and urinary protein (HR 1.55; P < 0.01)., Conclusions: For early intervention against a reduction in the eGFR, detecting mild increases in FPG ≥105 mg/dL in patients with CKD with or without diabetes is useful., (© 2024 The Author(s). Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.) more...- Published
- 2024
- Full Text
- View/download PDF