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Influence of chronic kidney disease on hospitalization, chronic dialysis, and mortality in Japanese men: a longitudinal analysis.

Abstract：

BACKGROUND:Little is known concerning the risk of hospitalization and the risk of death before receiving dialysis by the stage of chronic kidney disease (CKD) in Japan. METHODS:The subjects comprised a total of 13,911 Japanese men (mean age 49.2 ± 9.9 years). Based on the results of a health checkup performed in 2006, they were divided into 5 groups according to their estimated glomerular filtration rate (GFR) levels and dialysis status: GFR ≥60, 45-59, 30-44, <30 mL/min/1.73 m2, and undergoing dialysis. From 2006 through to 2013, we investigated their hospitalization, dialysis initiation, and cause-specific death. The adjusted hazard ratios (HRs) for each end point were calculated compared with the GFR ≥60 mL/min/1.73 m2 group using a Cox proportional hazard model. RESULTS:A lower GFR was independently associated with higher risks of overall hospitalization, dialysis initiation, and all-cause death. In particular, the HRs for long-term hospitalization (≥1 month a year), dialysis, and cardiovascular disease (CVD) death markedly increased along with a decreased GFR. The rate ratios of dialysis to all-cause death (calculated based on the incidences of dialysis and death per 1000 person-years) were 0.03 (0.11 vs. 3.19), 0.08 (0.29 vs. 3.62), 0.51 (12.5 vs. 24.7), and 4.50 (179.8 vs. 40.0) for GFR ≥60, 45-59, 30-44, and <30 mL/min/1.73 m2, respectively. CONCLUSION:In Japanese men, although the risk of CVD death before dialysis initiation can never be ignored, CKD patients aged <60 years with a GFR of <30 mL/min/1.73 m2 are more likely to undergo dialysis prior to death.

journal_name

Clin Exp Nephrol

journal_title

Clinical and experimental nephrology

authors

Nishikawa K,Takahashi K,Yamada R,Kinaga T,Masato M,Yamamoto M

doi

10.1007/s10157-016-1293-5

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

316-323

issue

2

eissn

1342-1751

issn

1437-7799

pii

10.1007/s10157-016-1293-5

journal_volume

21

pub_type

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