Lifestyle behaviors associated with the initiation of renal replacement therapy in Japanese patients with chronic kidney disease: a retrospective cohort study using a claims database linked with specific health checkup results.
10.1186/s12199-021-01022-3
- Author:
Azusa HARA
1
;
Takumi HIRATA
2
;
Tomonori OKAMURA
3
;
Shinya KIMURA
4
;
Hisashi URUSHIHARA
5
Author Information
1. Division of Drug Development and Regulatory Science, Faculty of Pharmacy, Keio University, 1-5-30, Shibakoen, Minato-ku, Tokyo, 105-8512, Japan.
2. Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan.
3. Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.
4. JMDC Inc., Tokyo, Japan.
5. Division of Drug Development and Regulatory Science, Faculty of Pharmacy, Keio University, 1-5-30, Shibakoen, Minato-ku, Tokyo, 105-8512, Japan. urushihara.hisashi@keio.jp.
- Publication Type:Journal Article
- Keywords:
Chronic kidney disease;
Database;
Japanese workers;
Lifestyle behaviors;
Renal replacement therapy
- MeSH:
Aged;
Cohort Studies;
Databases, Factual;
Disease Progression;
Female;
Health Benefit Plans, Employee;
Humans;
Japan/epidemiology*;
Life Style;
Male;
Meals;
Middle Aged;
Proportional Hazards Models;
Renal Insufficiency, Chronic/therapy*;
Renal Replacement Therapy;
Retrospective Studies;
Sleep;
Smoking/epidemiology*
- From:Environmental Health and Preventive Medicine
2021;26(1):102-102
- CountryJapan
- Language:English
-
Abstract:
BACKGROUND:Chronic kidney disease (CKD) is an independent risk factor for progression to an end-stage renal disease requiring dialysis or kidney transplantation. We investigated the association of lifestyle behaviors with the initiation of renal replacement therapy (RRT) among CKD patients using an employment-based health insurance claims database linked with specific health checkup (SHC) data.
METHODS:This retrospective cohort study included 149,620 CKD patients aged 40-74 years who underwent a SHC between April 2008 and March 2016. CKD patients were identified using ICD-10 diagnostic codes and SHC results. We investigated lifestyle behaviors recorded at SHC. Initiation of RRT was defined by medical procedure claims. Lifestyle behaviors related to the initiation of RRT were identified using a Cox proportional hazards regression model with recency-weighted cumulative exposure as a time-dependent covariate.
RESULTS:During 384,042 patient-years of follow-up by the end of March 2016, 295 dialysis and no kidney transplantation cases were identified. Current smoking (hazard ratio: 1.87, 95% confidence interval, 1.04─3.36), skipping breakfast (4.80, 1.98─11.62), and taking sufficient rest along with sleep (2.09, 1.14─3.85) were associated with the initiation of RRT.
CONCLUSIONS:Among CKD patients, the lifestyle behaviors of smoking, skipping breakfast, and sufficient rest along with sleep were independently associated with the initiation of RRT. Our study strengthens the importance of monitoring lifestyle behaviors to delay the progression of mild CKD to RRT in the Japanese working generation. A substantial portion of subjects had missing data for eGFR and drinking frequency, warranting verification of these results in prospective studies.
