Together, these three laws comprise a health checkup system providing lifetime urine testing. We are privileged to have such an ideal screening system in terms of early detection, prevention and education for kidney disease. Chronic glomerulonephritis is decreasing as a cause find more of ESKD. This may be attributed to early detection and treatment through the mandatory urine checkup system in Japan. In the urine protein test by dipstick, the incidence of Selleck Wnt inhibitor proteinuria is as low as 0.5%, but the possibility of these subjects entering dialysis is as high as 5–10%. About 3% of subjects with both proteinuria and hematuria have had to have dialysis therapy within 10 years. There was no

difference in the cumulative incidence of dialysis between cases with hematuria alone (mostly in elderly women) and those without proteinuria or hematuria. The cumulative incidence of dialysis was 16% for 3+ or greater and about 7% for 2+ of proteinuria by dipstick during 17-year follow-up. These results suggest that the risk of developing ESKD is proportional to Pitavastatin the degree of proteinuria (Fig. 6-1). Fig. 6-1 Cumulative incidence of ESKD in

CKD patients with different degrees of proteinuria. The data are quoted, with modification, from Iseki K et al. (Kidney Int. 2003;63:1468–1474) The risk of developing cardiovascular disease (CVD) increases with the reduction of kidney function, and it becomes even higher when proteinuria is present (Fig. 6-2). The American Heart Association (AHA), therefore, recommends the urine test for CVD patients, because proteinuria Interleukin-2 receptor is considered to be an important risk factor for CVD progression.

Fig. 6-2  Declining GFR and increasing proteinuria as independent and additional risk factors. The data are quoted, with modification, from K/DOQI Clinical Practice Guidelines [Am. J. Kidney Dis. 2004;43(Suppl 1):S1–S290] Recently, with the prevalence of obesity and unhealthy lifestyles at younger ages, the incidence of abnormal urine tests is increasing. This justifies urine testing in school-age children. Chronic glomerulonephritis, such as IgA nephropathy, often detected by health checkups in Japan, can be successfully treated by intensive therapy, including the early use of corticosteroid or immunosuppressive agents. Thus, early detection and treatment are very important. The earliest marker for diabetic nephropathy is microalbuminuria, which can be alleviated or normalized by ACE inhibitors and/or ARBs and by strict control of blood glucose.”
“Introduction Nearly 50% of the global population lives in the Asian Pacific region, including the world’s two large and most populous countries, China and India, which together account for over 35%, and are the two countries with the highest incidence and prevalence of chronic kidney disease (CKD) dialysis patients (CKD 5-D).