Relationship between kidney function and healthy life expectancy: A historical cohort study

Abstract Background The impact of chronic kidney disease (CKD) on healthy life expectancy and healthcare costs requires research. This study examined associations between CKD and healthy life expectancy, and its economic burden. Methods This study of community-dwelling adults residing in Hakui City,...

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Main Authors: Hisayuki Ogura, Tadashi Toyama, Hikaru Samuta, Kohei Hirako, Tomoya Itatani, Shiori Nakagawa, Megumi Oshima, Shinji Kitajima, Akinori Hara, Norihiko Sakai, Miho Shimizu, Tomoyuki Takura, Takashi Wada, Yasunori Iwata
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-024-03843-0
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author Hisayuki Ogura
Tadashi Toyama
Hikaru Samuta
Kohei Hirako
Tomoya Itatani
Shiori Nakagawa
Megumi Oshima
Shinji Kitajima
Akinori Hara
Norihiko Sakai
Miho Shimizu
Tomoyuki Takura
Takashi Wada
Yasunori Iwata
author_facet Hisayuki Ogura
Tadashi Toyama
Hikaru Samuta
Kohei Hirako
Tomoya Itatani
Shiori Nakagawa
Megumi Oshima
Shinji Kitajima
Akinori Hara
Norihiko Sakai
Miho Shimizu
Tomoyuki Takura
Takashi Wada
Yasunori Iwata
author_sort Hisayuki Ogura
collection DOAJ
description Abstract Background The impact of chronic kidney disease (CKD) on healthy life expectancy and healthcare costs requires research. This study examined associations between CKD and healthy life expectancy, and its economic burden. Methods This study of community-dwelling adults residing in Hakui City, Ishikawa Prefecture, Japan used data from the National Health Insurance database between 2012 and 2022. Participants were grouped by baseline estimated glomerular filtration rate (eGFR) (< 45, ≥ 45 to < 60, ≥60 to < 75, ≥75 to < 90, and ≥ 90 mL/min/1.73 m²). The primary endpoint was a composite of becoming a care level ≥ 2 or death. Multivariable Cox proportional hazards models were used to calculate the risk regarding time to the primary endpoint. Secondary endpoints were the annual medical and long-term care costs. Results The 5,592 participants had a mean follow-up of 6.4 years. The hazard ratio was 1.86 (95% confidence interval [CI]: 1.35 to 2.55) for the eGFR < 45 group and 1.60 (95% CI: 1.13 to 2.25) for the eGFR ≥ 90 group, both compared with the eGFR ≥ 60 to < 75 group. Both annual costs were significantly higher in the lower eGFR groups than in the higher eGFR groups. For the eGFR < 45 group, the median medical care cost was 0.38 million yen/year in all participants and the median long-term care cost was 0.40 million yen/year in primary endpoint achievers. A lower eGFR was correlated with longer unhealthy years of life. Conclusions Higher and lower eGFRs were associated with increased risks of reduced healthy life expectancy. A lower eGFR was associated with higher medical and long-term care costs.
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spelling doaj-art-520fdf9e186c41188ee206d337269e462025-01-19T12:13:34ZengBMCBMC Nephrology1471-23692025-01-012611810.1186/s12882-024-03843-0Relationship between kidney function and healthy life expectancy: A historical cohort studyHisayuki Ogura0Tadashi Toyama1Hikaru Samuta2Kohei Hirako3Tomoya Itatani4Shiori Nakagawa5Megumi Oshima6Shinji Kitajima7Akinori Hara8Norihiko Sakai9Miho Shimizu10Tomoyuki Takura11Takashi Wada12Yasunori Iwata13Department of Nephrology and Rheumatology, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Nephrology and Rheumatology, Graduate School of Medical Sciences, Kanazawa UniversityFaculty of Transdisciplinary Sciences for Innovation, Institute of Transdisciplinary Sciences for Innovation, Kanazawa UniversityFaculty of Interdisciplinary Economics Department of Interdisciplinary Economics, Kinjo UniversitySchool of Nursing, Faculty of Medicine, University of MiyazakiDepartment of Nephrology and Rheumatology, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Nephrology and Rheumatology, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Nephrology and Rheumatology, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Hygiene and Public Health, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Nephrology and Rheumatology, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Nephrology and Rheumatology, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of TokyoDepartment of Nephrology and Rheumatology, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Nephrology and Rheumatology, Graduate School of Medical Sciences, Kanazawa UniversityAbstract Background The impact of chronic kidney disease (CKD) on healthy life expectancy and healthcare costs requires research. This study examined associations between CKD and healthy life expectancy, and its economic burden. Methods This study of community-dwelling adults residing in Hakui City, Ishikawa Prefecture, Japan used data from the National Health Insurance database between 2012 and 2022. Participants were grouped by baseline estimated glomerular filtration rate (eGFR) (< 45, ≥ 45 to < 60, ≥60 to < 75, ≥75 to < 90, and ≥ 90 mL/min/1.73 m²). The primary endpoint was a composite of becoming a care level ≥ 2 or death. Multivariable Cox proportional hazards models were used to calculate the risk regarding time to the primary endpoint. Secondary endpoints were the annual medical and long-term care costs. Results The 5,592 participants had a mean follow-up of 6.4 years. The hazard ratio was 1.86 (95% confidence interval [CI]: 1.35 to 2.55) for the eGFR < 45 group and 1.60 (95% CI: 1.13 to 2.25) for the eGFR ≥ 90 group, both compared with the eGFR ≥ 60 to < 75 group. Both annual costs were significantly higher in the lower eGFR groups than in the higher eGFR groups. For the eGFR < 45 group, the median medical care cost was 0.38 million yen/year in all participants and the median long-term care cost was 0.40 million yen/year in primary endpoint achievers. A lower eGFR was correlated with longer unhealthy years of life. Conclusions Higher and lower eGFRs were associated with increased risks of reduced healthy life expectancy. A lower eGFR was associated with higher medical and long-term care costs.https://doi.org/10.1186/s12882-024-03843-0Cohort studyHealthy life expectancyKidney functionLong-term care costsMedical care costs
spellingShingle Hisayuki Ogura
Tadashi Toyama
Hikaru Samuta
Kohei Hirako
Tomoya Itatani
Shiori Nakagawa
Megumi Oshima
Shinji Kitajima
Akinori Hara
Norihiko Sakai
Miho Shimizu
Tomoyuki Takura
Takashi Wada
Yasunori Iwata
Relationship between kidney function and healthy life expectancy: A historical cohort study
BMC Nephrology
Cohort study
Healthy life expectancy
Kidney function
Long-term care costs
Medical care costs
title Relationship between kidney function and healthy life expectancy: A historical cohort study
title_full Relationship between kidney function and healthy life expectancy: A historical cohort study
title_fullStr Relationship between kidney function and healthy life expectancy: A historical cohort study
title_full_unstemmed Relationship between kidney function and healthy life expectancy: A historical cohort study
title_short Relationship between kidney function and healthy life expectancy: A historical cohort study
title_sort relationship between kidney function and healthy life expectancy a historical cohort study
topic Cohort study
Healthy life expectancy
Kidney function
Long-term care costs
Medical care costs
url https://doi.org/10.1186/s12882-024-03843-0
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