The Kidney Early Evaluation Program (KEEP) of Japan: results from the initial screening period

Abstract

The International Kidney Evaluation Association Japan evaluated chronic kidney disease (CKD) in Japan, using a Japanese version of the US National Kidney Foundation's Kidney Early Evaluation Program (KEEP). The screening criteria for the first 1065 participants were presence of diabetes or hypertension, or family history of diabetes, hypertension, or kidney disease. Mean age was 59.7±16.1 years; 501 participants were men, 564 women. Of participants, 26.9% had diabetes, 59.2% had hypertension (with an additional 21.5% diagnosed after the program), 16.9% had history of diabetes and hypertension together, and 30.6% had neither, but had family history of diabetes, hypertension, or kidney disease. CKD (stages 1–4) prevalence was 26.7%, defined by albumin–creatinine ratio and estimated glomerular filtration rate. CKD prevalence was 35.0% among diabetic participants, 34.8% among hypertensive participants, and 37.1% among participants with cardiovascular disease (CVD). The following baseline conditions were significantly associated with discovered CKD: diabetes, odds ratio 1.71 (95% confidence interval 1.28–2.30); hypertension, 3.42 (2.15–5.44); CVD, 1.88 (1.37–2.57). CKD prevalence was high compared with the general Japanese population. KEEP Japan seems to define a high-risk population with evidence of CKD based on the targeted nature of the program.