{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T04:56:41Z","timestamp":1768366601493,"version":"3.49.0"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic kidney disease (CKD) contributes to poor renal and cardiovascular outcomes, necessitating early detection and intervention. The current study investigated the variability in CKD management practices across clinical specialties in Japan. Real-world electronic health records of 788,059 patients with suspected CKD between January 2004 and September 2021 were analyzed. Only 1.2% of patients received care in a nephrology department. However, nephrology involvement significantly increased the proportion of patients undergoing quantitative urine protein assessments and receiving a CKD diagnosis. This trend was evident in cardiology, urology, rheumatology, and endocrinology\/metabolism departments, where nephrology involvement resulted in more frequent testing and earlier CKD diagnosis. Despite these benefits, the overall proportion of patients with nephrology involvement remains low, especially in the early stages of CKD. These findings highlight the considerable variability in CKD diagnosis and management approaches across clinical departments. Because quantitative urine protein assessment is critical for precise CKD diagnosis and patient care, strategies such as promoting interdepartmental collaboration with nephrology departments and establishing standardized diagnostic protocols tailored to individual specialties and facilities should be prioritized. Implementing such facility- and specialty-specific measures is crucial for enhancing early CKD detection and intervention, ultimately improving clinical outcomes in patients at risk of CKD progression.<\/jats:p>","DOI":"10.1038\/s41598-025-31735-2","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T21:51:25Z","timestamp":1765230685000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management status of patients with chronic kidney disease across medical specialties in Japan: a real-world data analysis"],"prefix":"10.1038","volume":"16","author":[{"given":"Shoichi","family":"Maruyama","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuhiro","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirobumi","family":"Igawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuru","family":"Hoshino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoichiro","family":"Inokuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuji","family":"Kaneko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirokazu","family":"Takaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asuka","family":"Ozaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"31735_CR1","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/S0140-6736(13)60595-4","volume":"382","author":"RT Gansevoort","year":"2013","unstructured":"Gansevoort, R. T. et al. Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention. Lancet 382, 339\u2013352. https:\/\/doi.org\/10.1016\/S0140-6736(13)60595-4 (2013).","journal-title":"Lancet"},{"key":"31735_CR2","doi-asserted-by":"publisher","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","year":"2024","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 105, S117\u2013S314. https:\/\/doi.org\/10.1016\/j.kint.2023.10.018 (2024).","journal-title":"Kidney Int."},{"key":"31735_CR3","doi-asserted-by":"publisher","first-page":"5172","DOI":"10.1038\/s41598-024-55827-7","volume":"14","author":"T Tanaka","year":"2024","unstructured":"Tanaka, T. et al. Population characteristics and diagnosis rate of chronic kidney disease by eGFR and proteinuria in Japanese clinical practice: an observational database study. Sci. Rep. 14, 5172. https:\/\/doi.org\/10.1038\/s41598-024-55827-7 (2024).","journal-title":"Sci. Rep."},{"key":"31735_CR4","doi-asserted-by":"publisher","first-page":"sfae228","DOI":"10.1093\/ckj\/sfae228","volume":"17","author":"S Maruyama","year":"2024","unstructured":"Maruyama, S. et al. Cardiovascular, renal and mortality risk by the KDIGO heatmap in Japan. Clin. Kidney J. 17, sfae228. https:\/\/doi.org\/10.1093\/ckj\/sfae228 (2024).","journal-title":"Clin. Kidney J."},{"key":"31735_CR5","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1053\/j.ajkd.2008.12.034","volume":"53","author":"S Matsuo","year":"2009","unstructured":"Matsuo, S. et al. Revised equations for estimated GFR from serum creatinine in Japan. Am. J. Kidney Dis. 53, 982\u2013992. https:\/\/doi.org\/10.1053\/j.ajkd.2008.12.034 (2009).","journal-title":"Am. J. Kidney Dis."},{"key":"31735_CR6","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1053\/j.ajkd.2017.06.025","volume":"70","author":"E Fung","year":"2017","unstructured":"Fung, E. et al. Receipt of nephrology care and clinical outcomes among veterans with advanced CKD. Am. J. Kidney Dis. 70, 705\u2013714. https:\/\/doi.org\/10.1053\/j.ajkd.2017.06.025 (2017).","journal-title":"Am. J. Kidney Dis."},{"key":"31735_CR7","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1681\/ASN.2022030373","volume":"33","author":"O Swartling","year":"2022","unstructured":"Swartling, O. et al. Sex differences in the recognition, monitoring, and management of CKD in health care: an observational cohort study. J. Am. Soc. Nephrol. 33, 1903\u20131914. https:\/\/doi.org\/10.1681\/ASN.2022030373 (2022).","journal-title":"J. Am. Soc. Nephrol."},{"key":"31735_CR8","doi-asserted-by":"publisher","first-page":"2116","DOI":"10.1093\/ckj\/sfac165","volume":"15","author":"JD Kampmann","year":"2022","unstructured":"Kampmann, J. D. et al. Referral rate of chronic kidney disease patients to a nephrologist in the region of Southern Denmark: results from KidDiCo. Clin. Kidney J. 15, 2116\u20132123. https:\/\/doi.org\/10.1093\/ckj\/sfac165 (2022).","journal-title":"Clin. Kidney J."},{"key":"31735_CR9","unstructured":"Naito, T. et al. Current status of and regional differences in CKD management and medical cooperation in Japan: from the results of a nationwide questionnaire survey for primary care physicians. Nihon Jinzo Gakkai Shi. 55, 1391\u20131400 (2013)."},{"key":"31735_CR10","doi-asserted-by":"publisher","first-page":"e012655","DOI":"10.1161\/JAHA.119.012655","volume":"8","author":"C Linde","year":"2019","unstructured":"Linde, C. et al. Real-world associations of renin-angiotensin-aldosterone system inhibitor dose, hyperkalemia, and adverse clinical outcomes in a cohort of patients with new-onset chronic kidney disease or heart failure in the United Kingdom. J. Am. Heart Assoc. 8, e012655. https:\/\/doi.org\/10.1161\/JAHA.119.012655 (2019).","journal-title":"J. Am. Heart Assoc."},{"key":"31735_CR11","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12882-025-03944-4","volume":"26","author":"L Cheng","year":"2025","unstructured":"Cheng, L., Hu, N., Song, D., Liu, L. & Chen, Y. Early versus late nephrology referral and patient outcomes in chronic kidney disease: an updated systematic review and meta-analysis. BMC Nephrol. 26, 25. https:\/\/doi.org\/10.1186\/s12882-025-03944-4 (2025).","journal-title":"BMC Nephrol."},{"key":"31735_CR12","doi-asserted-by":"publisher","first-page":"e0282163","DOI":"10.1371\/journal.pone.0282163","volume":"18","author":"Y Iwata","year":"2023","unstructured":"Iwata, Y. et al. Referral pattern to nephrologist and prognosis in diabetic kidney disease patients: single center retrospective cohort study. PLoS One. 18, e0282163. https:\/\/doi.org\/10.1371\/journal.pone.0282163 (2023).","journal-title":"PLoS One"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-31735-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-31735-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-31735-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T22:09:50Z","timestamp":1768342190000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-31735-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["31735"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-31735-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,8]]},"assertion":[{"value":"27 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was sponsored by AstraZeneca K.K. H.I., M.H., and A.O. are employees of AstraZeneca K.K. S.I., S.K., and H.T. are employees of JMDC Inc., a healthcare analytics company that received funding for this research from AstraZeneca K.K. S.M. and T.T. have received lecture fees from AstraZeneca K.K.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1536"}}