Trends in the prevalence of chronic kidney disease and its risk factors in a general Japanese population: The Hisayama Study

Background. Chronic kidney disease (CKD) is increasingly recognized as a leading public health issue. However, there are limited data assessing secular trends in the prevalence of CKD in general Asian communities. Methods. We performed three repeated cross-sectional surveys of residents aged >= 40 years in 1974 [2118 subjects (participation rate, 81.2%)], 1988 [2741 subjects (80.9%)] and 2002 [3297 subjects (77.6%)] in a Japanese community. We compared the prevalence of CKD [one or both of proteinuria and estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2)] and potential risk factors among the three surveys. Results. The prevalence of CKD increased significantly with time in men (13.8% [95% confidence interval (95% CI), 11.4-16.2%] in 1974, 15.9% [95% CI, 13.6-18.2%] in 1988 and 22.1% [95% CI, 19.6-24.6%] in 2002; P for trend < 0.001), but not in women (14.3% [95% CI, 12.2-16.4%], 12.6% [95% CI, 10.9-14.3%] and 15.3% [95% CI, 13.4-17.2%]; P for trend = 0.97). The frequencies of individuals with CKD Stages 3-5 (eGFR < 60 mL/min/1.73 m(2)) increased over the three decades in both sexes. Despite the widespread use of antihypertensive agents, the proportions of individuals with CKD who reached blood pressure of <130/80 mmHg were only 27.0% in men and 47.5% in women. The frequency of metabolic disorders including diabetes, hypercholesterolaemia and obesity increased over the three decades in both sexes. Conclusions. The prevalence of CKD increased significantly in men, but not in women over the last three decades in a general Japanese population. Our findings support the requirement for a comprehensive treatment for hypertension and metabolic disorders to reduce the burden of CKD.