Epidemiological and clinico-pathological study on renal diseases observed in the autopsy cases in Hisayama population, Kyushu Island, Japan

Abstract As part of the population study in Hisayama, frequency and type of renal disease was studied. The materials consisted of 270 autopsy cases, 81.2% of total deaths occurring during the period of 10 yr from 1961 to 1971 among 1621 subjects, covering approximately 90% of the total population aged 40 and over at entry. According to standardized criteria for the estimation of renal vascular changes, nephrosclerosis was observed with the highest frequency (34.1%), followed by interstitial nephritis (4.8%), renal infarcts (4.4%) and diabetic nephrosclerosis (3.7%) of total autopsy cases. No case was found to have glomerulonephritis or malignant nephrosclerosis. Death is directly attributed to renal disease in 2.2% of the cases. Glomerular scarring became prominent with increasing age accompanying a reduction in kidney weight, and was more marked in hypertensive than normotensive subjects at each decade of age. Arteriolar nephrosclerosis developed with high frequency (70.5%) in diastolic hypertensive persons aged below 70 and 50.0% in those aged over 70. Arterial nephrosclerosis was in general less frequently found than arteriolar nephrosclerosis except for the cases aged over 70. In 35 autopsies with diabetes mellitus, diabetic glomerular lesions (nodular or diffuse form) were frequently found (28.6%), although most of them had only slight abnormality in glucose tolerance test. Glomerular scarring and arteriolar hyalinization, however, were almost uniformly found in diabetic kidneys.