Japonya’da kronik böbrek hastalığının epidemiyolojisi Epidemiology of chronic kidney disease in Japan

Makoto Ogawa Chiba University Hospital School of Medicine

20121115 Antarya, Turkey

Approximate distance 5620 miles or 9042.58 Kilometers

Experimental research

Clinical practice Management

Mori, Y., Akikusa, B., Mori, T., Ueda, S., Iesato, K., Yoshida, H., Ogawa, M., et al. (1986). Experimental systemic amyloidosis induced by immunization with syngeneic organ extracts in mice. J Exp Med 163, 1553-1565.

Contents of Presentation

1) Fundermentals of health and welfare in japan

2) ESRD（CKD ５） in Japan and the world

3) PPT in Japan and the world 4) CKD( 1-4) in Japan and the world

X 104

‘50 55 60 65 70 75 80 85 90 95 2000 2010 2012

>80

＞75

＞70

＞65

JAPAN Turkey US

Elderly people is rapidly increasing in Japan

128,056,026 72,752,325

Average height females by country

Average height of males by country

Turkey 172.6 Japan 171.6 cm

Turkey 161.4 Japan 158. 5 kg

Prevalence of obesity Among adults, 2009

Male

Female

Life expectancy at birth and 65

Japan At Birth At age of 65 Japan

Trends in life expectancy at birth, 1908-2008

1961

1961

Japanese universal heath coverage was established in 1961

Health expediture per capta

Japan

Mortality 2009

Stroke

Ischemic heart disease

Turkey

Japan

Total 30-39 40-49 50-59 60-69 >70

M

Japan

F

Salt intake of turkey and the world

Prevalence of unadjusted ESRD in the world

Taiwan

Japan

US

Turkey

Prevalence of ESRD Incidence of ESRD 2010

Prevalence and Incidence of patients Undergoing hemodialysis In Japan

>300,000

Causes of ESRD in the world

JAPAN Taiwan USA Germany Australia

Annual chanages in Prevarence and incidence of patients undergoing hemodialysis in Japan of ESRD in JAPAN and World

Others Unkown Nephrosclerosis GlomerulonephritisDM

Glomerulonephritis

DM

Nephrosclerosis

Prevalence Incidence

TURKEY

65-74 YO 0ver 75 YO

Effect of age in survival of patients on dialysis ～ international comparison ～

Cause of death in patients with ESRD on chronic dialysis in Japan

Age

The remaining years of patients on hemodialysis

Female in general Male in general

Female on HD Male on HD

Proportion of PD of patients on HD/PD USRDS 2009

PPT in Japan & Turkey

World

US JAPAN

.

Turkey Transplantation

PD(3%)

HD (93%)

JAPAN

4%

HD (77%) 10.1

12.9%

Turkey

PD

Hemodialysis costs &60,000 in each individuals for year. In total, > 18 bilion dollars have been used for ESRD every year costs . It means 0.2 % of total population uses 5 % of total health budget in Japan !!

Cost of hemodialysis in Japan and Turkey

Classification by eGFR and albuminuria (KDIGO 2009)

1/8 of total population >20 YO

Distribution of eGFR in Japan

eGFR from 1554 participants The average of eGFR is 80.2 with ± 15.2 mL/min/1.73 m2.

87.5 ± 19．9

90．3 ± 21．6

From CREST study in Turkey

Population of CKD in Japan and Turkey

13.3% of population (>20)

Stage 1 2 3 4 5

12 10 8 6 4 2 0 Total

Turkey Japan

16 14 12 10 8 6 4 2 0

15.5 13.3 7,307,315

13,300000

Stage 1-5

Age-difference of CKD stage

In Japan

Male Female

In Turkey

From

Results of urinalysis for proteinuria and hematuria in relation to the cumulative incidence rate of RRSD

Iseki K JMAJ 54:27-30, 2011

Prevalence of hypertension in CKD patients Japan and Turkey

Optimal >120/80 120-129 /80-84 130-139 /85-89 140-159 /90-99 160-179 /100-109 >180/110

Turkey

CKD(+) CKD(-)

Japan Kidney Blood Press Res 2012;36:36-46 Prevalence of hypertension

in CKD(+) patients

What is a high risk group for CKD?

Hisayama Study Average local town in Kyushu district

Hisayama

n= 39211

Under any treatment 12622 Missing data 992

39211

M:11636 F : 27575

Osaka Study

Summary of presentation Comparison of Japan and Turkey

Simmilarities 1) The prevalence of CKD/ERSD is growing.

2) The percentage of diabetes and hypertension increases as a cause of ESRD in both counties.

3) Aging affect the incidence and prognosis CKD/ERSD Dissimmilarities 1) Age ,average GFR ,CKD stage are different 2) M>F in Japan F>M in Turkey 3) Percentage of Transplatation as RRT is lower in Japan.

2011.3.11 East Japan Earthquake and Tunami

2011.10.23 Eastern Turkey Earthquakes Magnitude 7.2

Both countries have been suffered from great earthquakes