| Research Abstract |
We recently found regional differences in the incidence of end-stage renal disease (ESRD) in Japan, which is generally ethnically homogeneous. The number of ESRD patients entering maintenance dialysis therapy due to individual causes of renal disease in each prefecture was reported annually for a 6-year period by the Japanese Society for Dialysis Therapy. After combining data from several prefectures into 11 geopolitical regions in Japan, the mean annual incidence of ESRD across the 11 regions was correlated among the three causes of ESRD. There were significant regional differences in the incidence of ESRD due to chronic glomerulonephritis (CGN) (P<0.0001) and diabetic nephropathy (DMN) (P=0.0015), the distributions of which were similar to each other across the 11 regions. In contrast, no regional differences were found in the incidence of ESRD due to polycystic kidney disease (PKD) (P=0.6) as the major genetic disorder of the kidneys, suggesting that genetic backgrounds are relative
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ly uniform throughout Japan. Risk factors common to nephropathy progression, rather than an underlying disease incidence and genetic predisposition, might contribute to regional differences in the overall ESRD incidence in Japan. These findings had been reported as the article entitled "Different regional dynamics of end-stage renal disease in Japan by different causes" published in the Nephrology (10: 400-404, 2005).
Subsequently, we had worked on the present study, relating regional differences between ESRD dynamics and the amounts of nutrient intake in a nationwide population of Japan, which revealed that the renal protective effects of dietary restriction of protein. The results of the present study were suggested by animal models of progressive nephropathies but yet unproved by large-scale clinical trials, remained un-established even on a macro level of whole Japan through mapping approaches. These findings had been accepted for publication in the Journal of
Renal Nutrition (17: 118-125, 2007), entitled "Regional differences in end-stage renal disease and amount of protein intake in Japan". Less
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