Medical and Dental Visits of Chronic Kidney Disease-Diagnosed Participants Analyzed From the Specific Health Checkups Results in Japan: TAMA MED Project-CKD

Fujii

et al. 2020

Circ J

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Background: Atrial fibrillation (AF) and chronic kidney disease (CKD) are known risk factors for each other. In Tama City in Tokyo, 12-lead ECG and serum creatinine concentration have been included as essential examinations in specific health checkups to diagnose AF and CKD. In the present study, we investigated the impact of CKD classification on new-onset AF in the general population. Methods and Results: Among 13,478 subjects aged 40-74 years at entry (age, 65.6±7.8 years; men, 42.0%), renal impairment with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 and proteinuria were found in 15.5% and 4.6%, respectively. CKD severity in individual subjects was classified according to a heatmap of the Japanese Society of Nephrology as 81.3% in the green, 15.1% in the yellow, 2.5% in the orange, and 0.9% in the red. Of those without AF in 2012, it had developed in 115 up to 2017; thus, the new-onset AF incidence rate was 2.6/1,000 person-years. Hazard ratios and 95% confidence intervals for new-onset AF in each CKD classification were 1.50 (0.93-2.41, P=0.097) in the yellow, 2.53 (1.03-6.23, P=0.044) in the orange, and 4.65 (1.47-14.70, P=0.009) in the red compared with the green as a reference. Conclusions: CKD classification was significantly associated with new-onset AF in the general population. Thus, it would be useful for risk stratification of new-onset AF. Renal function evaluation is recommended in health checkups.

Section: Study Design Of the Tama Med Project-af And Ckdmentioning

confidence: 99%

Section: Study Design Of the Tama Med Project-af And Ckdmentioning

confidence: 99%

Impact of Chronic Kidney Disease Classification on New-Onset Atrial Fibrillation in the General Population　― The TAMA MED Project-AF and CKD ―

Fujii

et al. 2020

Circ J

Self Cite

“…The TAMA MED Projects (Project Atrial Fibrillation, [3][4][5] Chronic Kidney Disease [4][5][6] and Frail 2 ) were conducted by the Tama City Medical Association to analyse consecutive annual health check-up data for national health insurance in Japan. All authors contributed to this work and agreed with the content of the present manuscript.…”

Section: Methodsmentioning

confidence: 99%

Sarcopenia and coexistent risk factors detected using the ‘Yubi-wakka’ (finger-ring) test in adults aged over 65 years in the public annual health check-up in Tama City, Tokyo: a cross-sectional study

Fujii¹,

et al. 2022

BMJ Open

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ObjectivesTo examine the positive rate of sarcopenia using the ‘Yubi-wakka’ (finger-ring) test and associated risk factors among adults aged 65 years and older.DesignCross-sectional study.SettingWe used the Yubi-wakka test, which has been developed and validated as a predictor of sarcopenia, frailty, disability and mortality. A positive test result is indicated by a smaller calf circumference than the finger-ring. The test was administered during annual health check-ups among residents of Tama City, Japan.ParticipantsDuring the 2019 fiscal year, 12 894 individuals aged 65 years and older underwent the Yubi-wakka test at primary care clinics.InterventionsExaminees conducted the test themselves in a seated position. They formed a ring around their calf using both thumbs and index fingers and judged whether their calf was larger, the same or smaller than their finger-ring.Primary and secondary outcome measuresWe compared anthropometric and serological data between the positive (smaller calf) and negative (larger calf) test result groups.ResultsThe positive rate was 15.4% among men and 18.5% among women. The prevalence of a positive result was higher in those aged ≥80 years than in younger age groups in both sexes (men: 22.8%; women: 28.8%). Multivariate logistic regression analysis showed that a diagnosis of metabolic syndrome was a risk factor for detecting a positive test result in women aged 65–74 years (OR 3.445; 95% CI 1.44 to 8.29) and ≥75 years (OR 3.37; 95% CI 1.97 to 5.78).ConclusionsBecause the Japanese population is healthy and lives long, interventions against sarcopenia are important, especially for older adults aged >75 years. The presence of metabolic syndrome may be a risk factor for sarcopenia (as detected by the Yubi-wakka test) and future frailty, and requires closer attention, especially among women.

“…The average age was 73.1 6 9.0 years. In our previous report, the prevalence of CKD in specific health checkups for people 40-74 years of age (67.0 6 7.3 years) in 2015 was 19.8% [4]. This also reveals that the prevalence of CKD increases with age.…”

Section: Discussionmentioning

confidence: 67%

“…The TAMA MED Project-CKD and Project-AF were conducted as retrospective cohort studies to clarify the prevalence and incidence of CKD [4] and AF [5] in the general population and simultaneously research frailty [6]. The study protocol conformed to the Declaration of Helsinki and was approved by the ethics committee of our institution [approval number 529 (2017)].…”

Section: Study Design Of the Tama Med Project-ckd And Project-afmentioning

confidence: 99%

Anemia and atrial fibrillation as independent risk factors for new-onset chronic kidney disease: the TAMA-MED Project—CKD and AF

Clinical Kidney Journal

Fujii

et al. 2021

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Background Various risk factors have been identified for the new-onset or rapid deterioration of chronic kidney disease. However, it is thought that many risk factors that have not yet been clarified remain. Methods Based on the results of specific annual health checkups at Tama City (n = 18,383) in 2017 and 2018, we analyzed the factors that cause new-onset chronic kidney disease and the risk factors that rapidly worsen renal function. For new-onset chronic kidney disease, proteinuria and estimated glomerular filtration rate < 60 mL/min/1.73m2 were examined separately. Rapid deterioration of renal function was defined as an estimated glomerular filtration rate of ≥ 25% lower than the previous year. Results Multivariate analysis showed that, in addition to age and impaired glucose tolerance, anemia, and atrial fibrillation were risk factors for the new appearance of proteinuria. Risk factors for a decrease in estimated glomerular filtration rate < 60 mL/min/1.73m2 were age and hyperuricemia. Age, systolic hypertension, urinary protein and urinary occult blood, high triglycerides, and anemia were significant risk factors for the rapid deterioration of renal function in patients with chronic kidney disease stage 3 or later. Conclusions From the results of specific annual health checkups at Tama City, atrial fibrillation, anemia, and hyperuricemia were identified as risk factors for new-onset chronic kidney disease over a short period of 1 year. Anemia was also a factor for the rapid deterioration of kidney function in subjects with renal dysfunction.