Predictive risk factors for early-stage renal dysfunction: An analysis of specific health checkup data for the general Japanese population

Background and aims: Early prevention of chronic kidney disease is critical. We aimed to identify predictive risk factors for early-stage renal dysfunction.

Methods and results: This retrospective study analyzed specific health checkup data from the general Japanese population. We included 1385 adults who underwent a specific health checkup in 2013 and 2019 and had an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m² in 2013. The composite endpoint was the progression of renal dysfunction for 6 years, including doubling of serum creatinine levels, ≥30 % decline in eGFR, and ≥30 % increase in the urine albumin-to-creatinine ratio (UACR) for individuals with UACR ≥30 mg/gCre at baseline or progression to ≥30 mg/gCre for those with UACR <30 mg/gCre at baseline. Participants were categorized into groups with and without progression of renal dysfunction. Univariate analysis of health checkup data and questionnaire data collected in 2013 was conducted, followed by multiple logistic regression analyses. Significant between-group differences were observed in age, body weight, body mass index (BMI), waist circumference, medication for hypertension and hyperlipidemia, systolic and diastolic blood pressure, high-density lipoprotein cholesterol, diabetes, glycated hemoglobin (HbA1c), urine glucose qualitative, UACR, urine protein-to-creatinine ratio, current smoking, weight gain, and walking habits. Logistic regression analysis showed that BMI (odds ratio [95 % confidence interval]: 1.14 [1.07-1.24], P < 0.001), HbA1c (1.57 [1.24-1.98], P < 0.001), and walking habits (0.51 [0.33-0.80], P = 0.003) were significantly associated with renal dysfunction progression.

Conclusions: Higher BMI and HbA1c and lower walking habits were associated with early-stage renal dysfunction, even in the general population.