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Original article The associations of cardiovascular and lifestyle factors with mortality from chronic kidney disease as the underlying cause: the JACC study
Shuai Guo1,2, Tomoko Sankai3, Kazumasa Yamagishi1orcid , Tomomi Kihara1, Akiko Tamakoshi4, Hiroyasu Iso1,5
Epidemiol Health 2024;e2024077
DOI: https://doi.org/10.4178/epih.e2024077 [Accepted]
Published online: September 13, 2024
1Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan, Tsukuba, Japan
2Doctoral Program in Public Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan, Tsukuba, Japan
3Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan, Tsukuba, Japan
4Department of Public Health, Faculty of Medicine, Hokkaido University, Hokkaido, Japan, Sapporo, Japan
5National Center for Global Health and Medicine,Bureau of International Cooperation, Institute for Global Health Policy Research (iGHP), Tokyo, Japan
Corresponding author:  Kazumasa Yamagishi,
Email: yamagishi.kazumas.ge@u.tsukuba.ac.jp
Received: 13 March 2024   • Revised: 21 August 2024   • Accepted: 25 August 2024
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OBJECTIVES
This study investigated conventional cardiovascular and lifestyle risk factors affecting mortality from chronic kidney disease as the underlying cause in the general Japanese population.
METHODS
We conducted an 18.8-year follow-up study of 44,792 men and 61,522 women aged 40-79 from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk between 1986 and 1990. Cox proportional hazard models were used to analyze the association between risk factors and mortality from chronic kidney disease.
RESULTS
During the follow-up period, 373 participants (185 men and 188 women) died from chronic kidney disease. A body mass index of ≥27 kg/m2 (hazard ratio [95% confidence interval] = 2.00 [1.19-3.36] for men and 1.91 [1.19-3.07] for women, compared with 23.0-24.9 kg/m2), a history of hypertension (2.32 [1.67-3.22] for men and 2.01 [1.44-2.81] for women) and a history of diabetes mellitus (5.21 [3.68-7.37] for men and 7.10 [4.93-10.24] for women) were associated with an increased risk of mortality from chronic kidney disease in both sexes. In men, smoking was also associated with an increased risk (1.91 [1.25-2.90]), while current drinking (0.58 [0.34-0.98] for <23 g/day, 0.48 [0.29-0.80] for 23-45 g/day and 0.53 [0.32-0.86] for ≥46 g/day) and exercising ≥5 hours/week (0.42 [0.18-0.96]) were associated with a lower risk. Similar but non-significant associations for smoking and drinking were observed in women.
CONCLUSIONS
In addition to a history of hypertension and a history of diabetes mellitus, body mass index, smoking status, drinking status, and exercise habits were associated with the risk of mortality from chronic kidney disease.


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