Abstract
Objective. We investigated visit trends of participants with suspected Chronic Kidney Disease (CKD) who received secondary consultation after health checkups to identify effective countermeasures.
Design. We administered a questionnaire survey to Tokyo residents at medical institutions, in cooperation with the Tokyo Medical Association.
Participants and Setting. Participants were selected from a population of 586,766 individuals (mean age, 50.6 years; 63.6% male) attending a preventive health checkups for lifestyle-related diseases conducted by the Japan Health Insurance Association, Tokyo Branch in both 2012 and 2013.
Methods. CKD severity classification comprised urine protein results examined using a test paper method and eGFR level. We selected participants with red or orange CKD heat maps both years, and those with yellow heat maps if the eGFR level was reduced by 1.0 mL/min/1.73m2 or more from the previous year. Additionally, the data on hypertension, diabetes mellitus, dislipidemia and obesity were extracted for untreated participants from their receipt information. To investigate the visit trends among Tokyo residents, we administered a questionnaire survey at the medical institutions, in cooperation with the Tokyo Medical Association. We created the eGFR graphs indicating their renal function.
Results. Of the 5,210 untreated people (0.83%), 2,468 Tokyo residents received the survey; 345 (14.0%) returned the questionnaire. Analysis revealed 62.0% (214) “first visits”; 31.9% (110) visited a nephrologist. Of the 68.1% (235) who visited a primary care physician, 66.0% (155/235) “continued treatment or follow-up in the same hospital” and 8.9% (21) were “introduced to a nephrologist”. The questionnaire return rate of the group with the eGFR graph was significantly higher.
Conclusion. Primary care physicians play a major role in CKD countermeasures after a health check-up and they should be active in CKD treatment in cooperation with nephrologists.
