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Japonya’da kronik böbrek hastalığının epidemiyolojisi Epidemiology of chronic kidney disease in Japan
Makoto Ogawa Chiba University Hospital School of Medicine
20121115 Antarya, Turkey
Approximate distance 5620 miles or 9042.58 Kilometers
Experimental research
Clinical practice Management
Mori, Y., Akikusa, B., Mori, T., Ueda, S., Iesato, K., Yoshida, H., Ogawa, M., et al. (1986). Experimental systemic amyloidosis induced by immunization with syngeneic organ extracts in mice. J Exp Med 163, 1553-1565.
Contents of Presentation
1) Fundermentals of health and welfare in japan
2) ESRD(CKD 5) in Japan and the world
3) PPT in Japan and the world 4) CKD( 1-4) in Japan and the world
X 104
‘50 55 60 65 70 75 80 85 90 95 2000 2010 2012
>80
>75
>70
>65
JAPAN Turkey US
Elderly people is rapidly increasing in Japan
128,056,026 72,752,325
Average height females by country
Average height of males by country
Turkey 172.6 Japan 171.6 cm
Turkey 161.4 Japan 158. 5 kg
Prevalence of obesity Among adults, 2009
Male
Female
Life expectancy at birth and 65
Japan At Birth At age of 65 Japan
Trends in life expectancy at birth, 1908-2008
1961
1961
Japanese universal heath coverage was established in 1961
Health expediture per capta
Japan
Mortality 2009
Stroke
Ischemic heart disease
Turkey
Japan
Total 30-39 40-49 50-59 60-69 >70
M
Japan
F
Salt intake of turkey and the world
Prevalence of unadjusted ESRD in the world
Taiwan
Japan
US
Turkey
Prevalence of ESRD Incidence of ESRD 2010
Prevalence and Incidence of patients Undergoing hemodialysis In Japan
>300,000
Causes of ESRD in the world
JAPAN Taiwan USA Germany Australia
Annual chanages in Prevarence and incidence of patients undergoing hemodialysis in Japan of ESRD in JAPAN and World
Others Unkown Nephrosclerosis GlomerulonephritisDM
Glomerulonephritis
DM
Nephrosclerosis
Prevalence Incidence
TURKEY
65-74 YO 0ver 75 YO
Effect of age in survival of patients on dialysis ~ international comparison ~
Cause of death in patients with ESRD on chronic dialysis in Japan
Age
The remaining years of patients on hemodialysis
Female in general Male in general
Female on HD Male on HD
Proportion of PD of patients on HD/PD USRDS 2009
PPT in Japan & Turkey
World
US JAPAN
.
Turkey Transplantation
PD(3%)
HD (93%)
JAPAN
4%
HD (77%) 10.1
12.9%
Turkey
PD
Hemodialysis costs &60,000 in each individuals for year. In total, > 18 bilion dollars have been used for ESRD every year costs . It means 0.2 % of total population uses 5 % of total health budget in Japan !!
Cost of hemodialysis in Japan and Turkey
Classification by eGFR and albuminuria (KDIGO 2009)
1/8 of total population >20 YO
Distribution of eGFR in Japan
eGFR from 1554 participants The average of eGFR is 80.2 with ± 15.2 mL/min/1.73 m2.
87.5 ± 19.9
90.3 ± 21.6
From CREST study in Turkey
Population of CKD in Japan and Turkey
13.3% of population (>20)
Stage 1 2 3 4 5
12 10 8 6 4 2 0 Total
Turkey Japan
16 14 12 10 8 6 4 2 0
15.5 13.3 7,307,315
13,300000
Stage 1-5
Age-difference of CKD stage
In Japan
Male Female
In Turkey
From
Results of urinalysis for proteinuria and hematuria in relation to the cumulative incidence rate of RRSD
Iseki K JMAJ 54:27-30, 2011
Prevalence of hypertension in CKD patients Japan and Turkey
Optimal >120/80 120-129 /80-84 130-139 /85-89 140-159 /90-99 160-179 /100-109 >180/110
Turkey
CKD(+) CKD(-)
Japan Kidney Blood Press Res 2012;36:36-46 Prevalence of hypertension
in CKD(+) patients
What is a high risk group for CKD?
Hisayama Study Average local town in Kyushu district
Hisayama
n= 39211
Under any treatment 12622 Missing data 992
39211
M:11636 F : 27575
Osaka Study
Summary of presentation Comparison of Japan and Turkey
Simmilarities 1) The prevalence of CKD/ERSD is growing.
2) The percentage of diabetes and hypertension increases as a cause of ESRD in both counties.
3) Aging affect the incidence and prognosis CKD/ERSD Dissimmilarities 1) Age ,average GFR ,CKD stage are different 2) M>F in Japan F>M in Turkey 3) Percentage of Transplatation as RRT is lower in Japan.
2011.3.11 East Japan Earthquake and Tunami
2011.10.23 Eastern Turkey Earthquakes Magnitude 7.2
Both countries have been suffered from great earthquakes