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Kidney Week

Abstract: FR-PO943

Risk Analysis of Healthy Life Expectancy Based on Kidney Function Using the Long-Term Care and Medical Database

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Ogura, Hisayuki, Kanazawa Daigaku, Kanazawa, Ishikawa, Japan
  • Toyama, Tadashi, Kanazawa Daigaku, Kanazawa, Ishikawa, Japan
  • Kitajima, Shinji, Kanazawa Daigaku, Kanazawa, Ishikawa, Japan
  • Hara, Akinori, Kanazawa Daigaku, Kanazawa, Ishikawa, Japan
  • Iwata, Yasunori, Kanazawa Daigaku, Kanazawa, Ishikawa, Japan
  • Sakai, Norihiko, Kanazawa Daigaku, Kanazawa, Ishikawa, Japan
  • Shimizu, Miho, Kanazawa Daigaku, Kanazawa, Ishikawa, Japan
  • Wada, Takashi, Kanazawa Daigaku, Kanazawa, Ishikawa, Japan
Background

The world's population is rapidly aging, with the aging rate expected to reach 17.8% by 2060. Healthy life expectancy is known to be shortened by unhealthy diet, hypertension, smoking, obesity and diabetes. Kidney dysfunction is also expected to shorten healthy life expectancy due to its effects on physical inactivity, malnutrition, and atherosclerosis. This study aims to clarify the relationship between kidney function and healthy life expectancy.

Methods

This was a community-based historical cohort study of adults living from 2012 to 2022 in Hakui City, Ishikawa Prefecture, Japan. Participants were divided into five groups (<45, ≥45 to <60, ≥60 to <75, ≥75 to <89, and ≥90 mL/min/1.73 m2). The primary composite outcome was the event of unhealthy status (care level ≥2 or death). Care level 2 was a level of social support for those who have difficulty performing basic activities of daily living independently and require some form of nursing care in Japan's long-term care system. Baseline risk factors included age, sex, body mass index, current smoking status, diabetes mellitus, systolic blood pressure, and social support level. Multivariable Cox proportional hazards model adjusted for baseline risk factors was used to estimate the risk of the primary outcome by eGFR group. Total annual healthcare cost, the sum of annual medical and long-term care cost, were examined as a secondary outcome.

Results

The number of participants was 5,592, the mean age was 67 years, the mean eGFR was 70.9 mL/min/1.73 m2, and the mean follow-up was 6.5 years. During the observation period, 8.2% of the participants reached the primary outcome. For the primary outcome, using eGFR ≥60 to <75 as the reference, the hazard ratios (HRs) for eGFR ≥45 to <60 and eGFR <45 were 1.35 (95% CI 1.05, 1.75) and 1.93 (95% CI 1.41, 2.66), respectively. The HRs for the eGFR ≥75 to <90 and eGFR ≥90 groups were 1.48 (95% CI 1.14, 1.93) and 1.61 (95% CI 1.14, 2.28), respectively. The mean total healthcare cost for those who achieved the primary outcome was approximately 1,760,000 yen per year. The lower eGFR group had higher annual costs.

Conclusion

Both lower and higher eGFR were risk factors for becoming unhealthy, need for long-term care or death. Annual total healthcare costs were higher in people who became unhealthy.

Funding

  • Government Support – Non-U.S.