Blood pressure and risk of end-stage renal disease in a screened cohort

We prospectively studied a total of 107,192 subjects over 18 years of age (51,122 men and 56,070 women) who participated in dipstick urinalyses and blood pressure measurements in 1983. The subjects represented approximately 13.7% of the entire Okinawan adult population of 780,000 according to the 1980 Census. Independently, data for all dialysis patients registered from April 1, 1983 to March 31, 1994 were analyzed; the total number of end-stage renal disease (ESRD) dialysis patients was 2,009 (1,126 men and 883 women) during the study period. Dialysis patients who had been in the 1983 mass screening and who later required dialysis during the study period were identified and verified by reviewing the medical records. ESRD developed in 193 (105 men and 88 women) participants from the 1983 health screening. In this mass screening setting, high diastolic blood pressure was identified as the significant predictor of ESRD with an adjusted odds ratio of 1.39 and a 95% confidence interval of 1.17 to 1.64.