Chronic kidney disease (CKD) is defined as either kidney damage with urine, imaging, and histologic abnormalities, or a low estimated glomerular filtration rate (GFR) for more than 3 months. The GFR is calculated using either the Modification of Diet in Renal Disease (MDRD) Study equation or the Cockcroft-Gault formula. CKD is a risk factor for end-stage renal disease (ESRD) and cardiovascular disease. In Japan, the prevalence of ESRD is increasing and is currently more than 2,000 per million population. More than 40% of incident ESRD is due to diabetes mellitus (DM). The prevalence of a low GFR (<60 ml/min/1.73 m2) is estimated to be 20% of the adult population. Studies based on several community-based screening programs suggest that Japan has a higher prevalence of CKD than any other country. Early detection and treatment of CKD are necessary to decrease the incidence of ESRD and cardiovascular disease.
2008 by The Japanese Society of Internal Medicine