| Budget Amount *help |
¥1,850,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥150,000)
Fiscal Year 2007: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2006: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 2005: ¥700,000 (Direct Cost: ¥700,000)
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| Research Abstract |
Effect of Lifestyle-related factors on developing end-stage renal disease (ESRD)
There will be more than 2 million dialysis patients in the world by 2010, approximately 0.3 million in Japan alone. Community-based screening programs have provided data for several papers on this topic. Among them, the Okinawa General Health Maintenance Association, a nonprofit organization founded in 1972, conducts an annual large community-based health examination screening program. Approximately 14% of the total adult population of Okinawa participated in each screening. The ESRD patient registry in Okinawa was used to investigate the outcome of the screenees. All chronic dialysis patients residing in the prefecture who survived for at least 1 month on scheduled dialysis were included in the registry. All patients (n=5246) were followed-up until the occurrence of a major medical event or until January 2001, whichever occurred first, and all outcomes were verified.
Using the two registries, we identified
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screening participants who later entered a dialysis program. Furthermore, patient data were verified by medical records. Important predictors of developing ESRD are dipstick・positive proteinuria and hypertension. Low GFR per se, which is often observed in the elderly population, is not a strong predictor of developing ESRD unless associated with proteinuria. Other significant risk factors are obesity and metabolic syndrome. Both the prevalence and incidence of CKD increase with an increase in the number of components of metabolic syndrome. The relationship between baseline BMI and the cumulative incidence of ESRD is linear, particularly in men, but a similar trend in both men and women has been reported.
Incidence and prevalence of CKD are closely related with the lifestyle such as diet, exercise, tobacco, and other cultural differences. Research on the relationship between CKD and metabolic syndrome may provide clue to understand better the role of lifestyle related factors and the age-related decline in GFR. Early detection and treatment of metabolic syndrome would be one of the cost-effective strategy for ever increasing prevalence of ESRD. Therefore, subjects with metabolic syndrome are candidates for the screening of CKD through dipstick proteinuria and measurement of serum creatinine. Less
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