Definition and validity of chronic kidney disease as a cardiovascular risk factor in the community-based population

2010 Fiscal Year Final Research Report

• Project/Area Number: 20590836
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Circulatory organs internal medicine
• Research Institution: Iwate Medical University
• Principal Investigator: NAKAMURA Motoyuki Iwate Medical University, 医学部, 教授 (40172449)
• Research Collaborator: TANAKA Humitaka 岩手医科大学, 医学部, 講師 (80405761) ; MAKITA Shinnji 岩手医科大学, 医学部, 准教授 (60306024) ; SEGAWA Rie 岩手医科大学, 医学部, 嘱託講師 (60347870) ; TAKAHASHI Tomohiro 岩手医科大学, 医学部, 助教 (80438449) ; SATO Kenyu 岩手医科大学, 医学部, 助教 (10593634) ; KOEDA Yorihiko 岩手医科大学, 医学部, 助教 (20609672)
• Project Period (FY): 2008 – 2010
• Keywords: 慢性腎臓病 / 心筋梗塞 / 脳卒中 / 心不全 / 尿蛋白 / 腎機能

Research Abstract

The definition of chronic kidney disease (CKD) which effectively discriminates high-risk subjects for cardiovascular events (CVE) from the Japanese general population has yet to be established. The aim of this study was to examine which definition of CKD might be useful for the prediction of CVE in our population. Baseline data including serum creatinine and proteinuria were determined in community- dwelling adults (n=14131, age=63). Estimated glomerular filtration rate (eGFR) was calculated using a modified MDRD equation, and CKD was defined by the three methods : (1) eGFR<60, (2) eGFR<60 or proteinuria positive, (3) eGFR<60 or proteinuria trace. CVE (stroke, heart failure, myocardial infarction/sudden death) were surveyed prospectively (mean follow-up = 2.7 years). As results, the most powerful definition of CKD for discriminating non-CKD in terms of CVE risk prediction was the definition of (3) (HR=1.36, 95%CI=1.07-1.74 ; p<0.05). In conclusion, the most useful definition of CKD for CVE risk-prediction in the Japanese general population appears to be eGFR<60 and/or urine protein trace.

Research Products

• [Journal Article] Association between metabolic syndrome and carotid atherosclerosis : relevance of combined criteria including the serum adiponectin level for the general population. (2011)
  • Author(s): Abiko A, Makita S, Naganuma Y, Nagai M, Nakamura M
  • Journal Title: Intern Med. 50(5) Pages: 381-387
  • Peer Reviewed
• [Journal Article] 危険因子「BNP」 (2011)
  • Author(s): 中村元行
  • Journal Title: 動脈硬化予防 印刷中
• [Journal Article] Chronic kidney disease is associated with increased carotid artery stiffness without morphological changes in participants of health check-up programs. (2010)
  • Author(s): Makita S, Abiko A, Naganuma Y, Nagai M, Nakamura M
  • Journal Title: Atherosclerosis 213(1) Pages: 306-310
  • Peer Reviewed
• [Journal Article] Comparison of low-density lipoprotein cholesterol concentrations measured by a direct homogeneous assay and by the Friedewald formula in a large community population. (2010)
  • Author(s): Tanno K, Okamura T, Ohsawa M, Onoda T, Itai K, Sakata K, Nakamura M, Ogawa A, Kawamura K, Okayama A.
  • Journal Title: Clin Chim Acta 411(21-22) Pages: 1774-1780
  • Peer Reviewed
• [Journal Article] Iwate-KENCO Study Group. Prehypertension subtype with elevated C-reactive protein : risk of ischemic stroke in a general Japanese population. (2010)
  • Author(s): Tanaka F, Makita S, Onoda T, Tanno K, Ohsawa M, Itai K, Sakata K, Onodera M, Koeda Y, Kawarura K, Terayama Y, Yoshida Y, Ogawa A, Okayama A, Nakamura M
  • Journal Title: Am J Hypertens 23(10) Pages: 1108-1113
  • Peer Reviewed
• [Journal Article] Plasma B-type natriuretic peptide level and cardiovascular events in chronic kidney disease in a community-based population. (2010)
  • Author(s): Sakuma M, Nakamura M, Tanaka F, Onoda T, Itai K, Tanno K, Ohsawa M, Sakata K, Yoshida Y, Kawamura K, Makita S, Okayama A.
  • Journal Title: Circ J. 74(4) Pages: 792-797
  • Peer Reviewed
• [Journal Article] 慢性腎臓病と血清高感度CRP値との関連性─地域住民における横断研究(IWATE-KENCO study) (2010)
  • Author(s): 肥田頼彦、中村元行, 他
  • Journal Title: 心臓 42(3) Pages: 329-335
  • Peer Reviewed
• [Journal Article] Low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio as a useful marker for early-stage carotid atherosclerosis. (2010)
  • Author(s): Tamada M, Makita S, Abiko A, Naganuma Y, Nagai M, Nakamura M
  • Journal Title: Metabolism 59(5) Pages: 653-657
  • Peer Reviewed
• [Journal Article] Standardized prevalence ratios for chronic hepatitis C virus infection among adult Japanese hemodialysis patients. (2010)
  • Author(s): Ohsawa M, Kato K, Itai K, Tanno K, Fujishima Y, Konda R, Okayama A, Abe K, Suzuki K, Nakamura M, et al.
  • Journal Title: J Epidemiol 20(1) Pages: 30-39
  • Peer Reviewed
• [Journal Article] Iwate KENCO Study Groups. Gender-specific risk stratification with plasma B-type natriuretic peptide for future onset of congestive heart failure and mortality in the Japanese general population. (2010)
  • Author(s): Nakamura M, Tanaka F, Onoda T, Takahashi T, Sakuma M, Kawamura K, Tanno K, Ohsawa M, Itai K, Sakata K, Makita S
  • Journal Title: Int J Cardiol 143(2) Pages: 124-129
  • Peer Reviewed
• [Journal Article] Predictive value of plasma B-type natriuretic peptide for ischemic stroke : a community-based longitudinal study. (2009)
  • Author(s): Takahashi T, Nakamura M, Onoda T, Ohsawa M, Tanno K, Itai K, Sakata K, Sakuma M, Tanaka F, Makita S, Yoshida Y, Ogawa A, Kawamura K, Okayama A.
  • Journal Title: Atherosclerosis 207(1) Pages: 298-303
  • Peer Reviewed
• [Journal Article] Serum C-reactive protein levels can be used to predict future ischemic stroke and mortality in Japanese men from the general population. (2009)
  • Author(s): Makita S, Nakamura M, Satoh K, Tanaka F, Onoda T, Kawamura K, Ohsawa M, Tanno K, Itai K, Sakata K, Okayama A, Terayama Y, Yoshida Y, Ogawa A.
  • Journal Title: Atherosclerosis 204(1) Pages: 234-238
  • Peer Reviewed
• [Journal Article] Cardiovascular risk factors in the Japanese northeastern rural population. (2009)
  • Author(s): Ohsawa M, Itai K, Tanno K, Onoda T, Ogawa A, Nakamura M, Kuribayashi T, Yoshida Y, Kawamura K, Sasaki S, Sakata K, Okayama A.
  • Journal Title: Int J Cardiol 137(3) Pages: 226-235
  • Peer Reviewed
• [Journal Article] Dietary intake of n-3 polyunsaturated fatty acids is inversely associated with CRP levels, especially among male smokers. (2008)
  • Author(s): Ohsawa M, Itai K, Onoda T, Tanno K, Sasaki S, Nakamura M, Ogawa A, Sakata K, Kawamura K, Kuribayashi T, Yoshida Y, Okayama A.
  • Journal Title: Atherosclerosis 201(1) Pages: 184-191
  • Peer Reviewed
• [Journal Article] Serum C-reactive protein levels and death and cardiovascular events in mild to moderate chronic kidney disease.
  • Author(s): Koeda Y, Nakamura M, et al.
  • Journal Title: International Heart J. In press
  • Peer Reviewed
• [Presentation] Plasma B-type Natriuretic Peptide is a Potent Predictive Biomarker for the Onset of Cardiovascular Events in a High Risk Population. (2010)
  • Author(s): 田中文隆、中村元行, 他
  • Organizer: American Heart Association 2010
  • Place of Presentation: Chicago
  • Year and Date: 20101100
• [Presentation] Plasma B-type Natriuretic Peptide is a Potent Predictive Biomarker for the Onset of Heart Failure in a High Risk Population. (2010)
  • Author(s): 佐藤権裕、中村元行, 他
  • Organizer: 日本心不全学会
  • Place of Presentation: 東京都
  • Year and Date: 20101100
• [Presentation] Plasma B-type Natriuretic Peptide Level is a Valid Tool for Cardiovascular Risk Stratification in Diabetes Subjects. (2010)
  • Author(s): 小野寺正幸, 中村元行, 他
  • Organizer: European Society of Cardiology 2010
  • Place of Presentation: Stockholm
  • Year and Date: 20100900
• [Presentation] Which Arterial Stiffness Parameter is the Most Useful Predictor for Cardiovascular Events and Death in the General Population (2010)
  • Author(s): 肥田頼彦、中村元行, 他
  • Organizer: European Society of Cardiology 2010
  • Place of Presentation: Stockholm
  • Year and Date: 20100900
• [Presentation] いずれの動脈スティフネス指標が心血管事故発症あるいは死亡の予測因子として有用か (2010)
  • Author(s): 小野寺正幸, 中村元行, 他
  • Organizer: 日本心臓病学会
  • Place of Presentation: 東京都
  • Year and Date: 20100900
• [Presentation] Framingham Risk Score, BNP, CRP, Urinary Albumin, and GFR : Which is the Best Predictor for Onset of Heart Failure in the General Population (2010)
  • Author(s): 瀬川利恵、中村元行, 他
  • Organizer: Heart Failure 2010
  • Place of Presentation: Berlin
  • Year and Date: 20100500
• [Presentation] 血漿BNPは糖尿病患者の心血管疾患発症高リスク群の層別化に有用である (2010)
  • Author(s): 瀬川利恵、中村元行, 他
  • Organizer: 日本内科学会総会
  • Place of Presentation: 東京都
  • Year and Date: 20100400
• [Presentation] Comparison of Utility of Plasma BNP for Risk Assessment of Cardiovascular Events Across Sex and Age in the General Population. (2010)
  • Author(s): 高橋智弘, 中村元行, 他
  • Organizer: 第74回日本循環器学会
  • Place of Presentation: 京都市
  • Year and Date: 20100300
• [Presentation] Framingham Risk Score, BNP, CRP, and GFR : Which is the Best Predictor for Cardiovascular Events in the Japanese General Population (2010)
  • Author(s): 瀬川利恵, 中村元行, 他
  • Organizer: 第74回日本循環器学会
  • Place of Presentation: 京都市
  • Year and Date: 20100300
• [Presentation] Prevalence of Physical and Mental Disability (Kaigo) and Death in Patients with Heart Failure in a Rural Community Based Study. (2010)
  • Author(s): 肥田頼彦, 中村元行, 他
  • Organizer: 第74回日本循環器学会
  • Place of Presentation: 京都市
  • Year and Date: 20100300
• [Presentation] Is NIPPON DATA80-derived Risk Prediction Valid for Short-term Risk Assessment for the Onset of Cardiovascular Disease in the General Population (2010)
  • Author(s): 田中文隆, 中村元行, 他
  • Organizer: 第74回日本循環器学会
  • Place of Presentation: 京都市
  • Year and Date: 20100300
• [Presentation] Incidence and Clinical Characteristics of Patients with Heart Failure: A Population-based Registry Study. (2010)
  • Author(s): 田中文隆, 中村元行, 他
  • Organizer: 第74回日本循環器学会
  • Place of Presentation: 京都市
  • Year and Date: 20100300
• [Presentation] Peripheral-BP, Central-BP, and PWV: Which is the Most Useful Predictor for Cardiovascular Events and Death in the General Population (2010)
  • Author(s): 小野寺正幸, 中村元行, 他
  • Organizer: 第74回日本循環器学会
  • Place of Presentation: 京都市
  • Year and Date: 20100300
• [Presentation] Abnormal Lipids Profile is an Important Factor Increasing Pulse Wave Velocity : Longitudinal Community-based Study (2010)
  • Author(s): 永野雅英、中村元行, 他
  • Organizer: 第74回日本循環器学会
  • Place of Presentation: 京都市
  • Year and Date: 20100300
• [Presentation] BNP、CRP、GFR、尿中アルブミン ; 一般住民においてどれが心不全発症予測指標として有用が (2009)
  • Author(s): 佐藤権裕, 中村元行, 他
  • Organizer: 第13回日本心不全学会
  • Place of Presentation: 福岡市
  • Year and Date: 20091000
• [Presentation] 睡眠時間と高血圧症罹患との関連:地域健常住民での横断研究 (2009)
  • Author(s): 田中文隆, 中村元行, 他
  • Organizer: 第46回日本臨床生理学会
  • Place of Presentation: 盛岡市
  • Year and Date: 20091000
• [Presentation] 日本人の心血管疾患発症リスク因子としての慢性腎疾患(CKD)の最適定義は (2009)
  • Author(s): 瀬川利恵、中村元行, 他
  • Organizer: 第106回日本内科学会
  • Place of Presentation: 東京都
  • Year and Date: 20090400
• [Presentation] Chronic Kidney Disease with Elevated C-reactive Protein : High Risk for Cardiovascular Events in Apparently Healthy Men from the General Population. (2009)
  • Author(s): 肥田頼彦、中村元行, 他
  • Organizer: 日本循環器学会総会
  • Place of Presentation: 大阪市
  • Year and Date: 2009-03-22
• [Presentation] Is Plasma B-type Natriuretic Peptide Measurement Valid for Prediction of Cardiovascular Events and Death in Chronic Kidney Disease? A Community-based Longitudinal Study. (2008)
  • Author(s): 佐久間雅文, 中村元行, 他
  • Organizer: American Heart Association 2008
  • Place of Presentation: New Orleans, USA
  • Year and Date: 20081100
• [Book] 循環器検査のグノーチィ・セアウトン(「BNPの正常値を考える」) (2009)
  • Author(s): 中村元行
  • Total Pages: 150-152
  • Publisher: シナジ