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The Predictive Factor for Future Renal Replacement Therapy among the Working Generation.

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Many working adults are at high risk for kidney disease and rapid estimated glomerular filtration rate (eGFR) decline. Urine protein levels identified these individuals, suggesting early screening can help prevent kidney failure.

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Area of Science:

  • Nephrology
  • Occupational Health
  • Preventive Medicine

Background:

  • Many individuals requiring renal replacement therapy (RRT) have underlying kidney issues from their working years, often undetected.
  • Early identification of high-risk individuals and timely interventions are crucial for reducing the prevalence of RRT.

Purpose of the Study:

  • To investigate the prevalence of high-risk cases for future RRT and rapid estimated glomerular filtration rate (eGFR) decline in the working population.
  • To identify predictive factors associated with these conditions among working adults.

Main Methods:

  • A prospective study analyzing five years of health checkup data from steelworks employees in Japan.
  • Risk assessment for future RRT based on annual eGFR changes (ΔeGFR) and projected remaining lifespan.

Main Results:

  • Out of 959 subjects, 7.8% (75) were identified as high-risk for RRT, and 4.8% (46) showed rapid eGFR decline (> -3 mL/min/1.73m²/year).
  • Logistic regression revealed urine protein level (dipstick test) as an independent predictor for both high RRT risk (OR 2.04) and rapid eGFR decline (OR 2.23).

Conclusions:

  • A significant number of active workers harbor latent risks for kidney disease progression.
  • Urine protein levels appear to be a valuable predictive marker for RRT risk, irrespective of baseline eGFR in the working generation.