Higher participation rates for specific health checkups are associated with a lower incidence of treated ESKD in Japan

Abstract

Background: A Japanese cohort study previously reported that not attending health checkups was associated with an increased risk of treated end-stage kidney disease (ESKD). The present study aimed to examine this association at the prefecture level. Methods: We conducted an ecological study of all prefectures in Japan (n = 47) using five sources of nationwide open data. We explored associations of participation rates for Specific Health Checkups (SHC participation rates), the estimated prevalence of chronic kidney disease (CKD), and the ratio of nephrology specialists for each prefecture with prefecture-specific standardized incidence rates (SIRs) of treated ESKD using structural equation modeling. Results: Prefecture-specific SHC participation rates ranged from 44.2% to 65.9%, and were negatively correlated with prefecture-specific SIRs and prevalence of CKD, and positively correlated with the ratio of nephrology specialists. SHC participation rates had significant negative effects on prefecture-specific SIRs (standardized estimate (β) = − 0.38, p = 0.01) and prefecture-specific prevalence of CKD (β = − 0.32, p = 0.02). Through SHC participation rates, the ratio of nephrology specialists had a significant indirect negative effect on prefecture-specific SIRs (β= − 0.14, p = 0.02). The model fitted the data well and explained 14% of the variance in SIRs. Conclusions: Our findings support the importance of increasing SHC participation rates at the population level and may encourage people to undergo health checkups.