Lifetime and age-conditional risk estimates of end-stage kidney disease requiring maintenance dialysis in Japan

Clin Exp Nephrol. 2020 Jun;24(6):518-525. doi: 10.1007/s10157-020-01860-5. Epub 2020 Feb 10.


Background: Lifetime risk is an epidemiologic measure that expresses the probability of disease in the remaining lifetime for an index age. It is also an easily understandable statistical measure used to communicate the absolute risk of disease to the lay population. The lifetime risk of end-stage kidney disease (ESKD) has never been reported for the Japanese population. Here, we used data from the Japanese Society of Dialysis Therapy (JSDT) to estimate the lifetime risk of ESKD by sex in Japan.

Methods: The lifetime risk of ESKD was estimated using life-table methods. We defined an incident case of ESKD as a patient with loss of kidney function that resulted in maintenance dialysis therapy. The number of incident cases of ESKD and number of ESKD deaths in 2017 were obtained from data published by the JSDT. The population and total number of deaths in Japan for the same year were obtained from National Vital Statistics. By including all-cause mortality, risks were adjusted for competing causes of death.

Results: The cumulative incidence of ESKD from birth until age 95 years was 3.14% [95% confidence interval (CI) 3.10-3.18] for men and 1.42% (1.39-1.44) for women. These probabilities illustrate that approximately 1 in 32 men and 1 in 71 women in Japan will develop ESKD that results in maintenance dialysis therapy in their lifetime.

Conclusions: Considerable sex differences were found in the lifetime risk of ESKD in Japan. This easily understandable information could be used to assist in public health education and planning.

Keywords: Age-conditional risk; Epidemiology; Lifetime risk; Mortality; Public health.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Japan / epidemiology
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / therapy
  • Life Tables
  • Male
  • Middle Aged
  • Renal Dialysis
  • Risk Factors
  • Sex Factors
  • Young Adult