Abstract
Background
For a definitive diagnosis of chronic kidney disease, at least 2 consecutive positive results of proteinuria with an interval of >3 months are required. However, most previous reports were based on single-screening data.
Patients and methods
The subjects in this study were participants in an annual health examination held in Ibaraki, Japan, between 1993 and 2003. The follow-up duration with serial urinalysis for 3 years of patients who were negative for proteinuria in the initial year was 330,614 person-years in males and 687,381 person-years in females among 81,854 male and 155,256 female subjects. We evaluated the incidence and risk factor for the incidence of proteinuria and persistent proteinuria.
Result
The annual incidence of proteinuria and persistent proteinuria was 1.31 and 0.33 % in males and 0.68 and 0.14 % in females. Among the subjects without hypertension and diabetes, the annual incidence was 0.81 and 0.16 % in males and 0.37 and 0.06 % in females, respectively. Risk analysis indicated that hypertension in males [hazard ratio (HR) 2.052] and females (2.477), diabetes in males (3.532) and females (3.534) and reduced renal function in males (3.097) and females (2.827) were significant positive risks for development of persistent proteinuria.
Conclusion
By annual urinalysis screening of the general population, 1 out of 303 male subjects and 1 out of 725 female subjects developed persistent proteinuria every year. Subjects with diabetes, hypertension and reduced renal function had a 2 or 3 times higher risk for the incidence of persistent proteinuria in both males and females.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Anavekar NS, McMurray JJ, Velazquez EJ, Solomon SD, Kober L, Rouleau JL, et al. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction. N Engl J Med. 2004;351:1285–95.
Weiner DE, Tighiouart H, Amin MG, Stark PC, MacLeod B, Griffith JL, et al. Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: a pooled analysis of community-based studies. J Am Soc Nephrol. 2004;15:1307–15.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305.
Yamagata K, Iseki K, Nitta K, Imai H, Iino Y, Matsuo S, et al. Chronic kidney disease perspectives in Japan and the importance of urinalysis screening. Clin Exp Nephrol. 2008;12:1–8.
Boulware LE, Jaar BG, Tarver-Carr ME, Brancati FL, Powe NR. Screening for proteinuria in US adults: a cost-effectiveness analysis. JAMA. 2003;290:3101–14.
Kondo M, Yamagata K, Hoshi SL, Saito C, Asahi K, Moriyama T, et al. Cost-effectiveness of chronic kidney disease mass screening test in Japan. Clin Exp Nephrol. 2011;16:279–91.
Ramirez SP, McClellan W, Port FK, Hsu SI. Risk factors for proteinuria in a large, multiracial, southeast Asian population. J Am Soc Nephrol. 2002;13:1907–17.
Chandie Shaw PK, Baboe F, van Es LA, van der Vijver JC, van de Ree MA, de Jonge N, et al. South-Asian type 2 diabetic patients have higher incidence and faster progression of renal disease compared with Dutch-European diabetic patients. Diabetes Care. 2006;29:1383–5.
Lightstone L, Rees AJ, Tomson C, Walls J, Winearls CG, Feehally J. High incidence of end-stage renal disease in Indo-Asians in the UK. QJM. 1995;88:191–5.
Iseki K, Iseki C, Ikemiya Y, Fukiyama K. Risk of developing end-stage renal disease in a cohort of mass screening. Kidney Int. 1996;49:800–5.
Nakai S, Masakane I, Akiba T, Iseki K, Watanabe Y, Itami N, et al. Overview of regular dialysis treatment in Japan (as of 31 December 2005). Ther Apher Dial. 2007;11:411–41.
Annual data report of ESRD in Taiwan. Nephrology TSo. 2006.
Yamagata K, Yamagata Y, Kobayashi M, Koyama A. A long-term follow-up study of asymptomatic hematuria and/or proteinuria in adults. Clin Nephrol. 1996;45:281–8.
Murakami M, Hayakawa M, Yanagihara T, Hukunaga Y. Proteinuria screening for children. Kidney Int Suppl. 2005;94:S23–7.
Yamagata K, Takahashi H, Suzuki S, Mase K, Hagiwara M, Shimizu Y, et al. Age distribution and yearly changes in the incidence of end-stage renal disease in Japan. Am J Kidney Dis. 2004;43:433–43.
Halbesma N, Kuiken DS, Brantsma AH, Bakker SJ, Wetzels JF, De Zeeuw D, et al. Macroalbuminuria is a better risk marker than low estimated GFR to identify individuals at risk for accelerated GFR loss in population screening. J Am Soc Nephrol. 2006;17:2582–90.
Imai E, Horio M, Yamagata K, Iseki K, Hara S, Ura N, et al. Slower decline of glomerular filtration rate in the Japanese general population: a longitudinal 10-year follow-up study. Hypertens Res. 2008;31:433–41.
Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from kidney disease: improving global outcomes (KDIGO). Kidney Int. 2005;67:2089–100.
1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines Subcommittee. J Hypertens. 1999;17:151–83.
Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999;130:461–70.
Koyama A, Igarashi M, Kobayashi M. Natural history and risk factors for immunoglobulin A nephropathy in Japan. Research Group on Progressive Renal Diseases. Am J Kidney Dis. 1997;29:526–32.
Wyatt RJ, Julian BA, Baehler RW, Stafford CC, McMorrow RG, Ferguson T, et al. Epidemiology of IgA nephropathy in central and eastern Kentucky for the period 1975 through 1994. Central Kentucky Region of the Southeastern United States IgA Nephropathy DATABANK Project. J Am Soc Nephrol. 1998;9:853–8.
Yamagata K, Takahashi H, Suzuki S, Mase K, Hagiwara M, Shimizu Y, et al. Age distribution and yearly changes in the incidence of ESRD in Japan. Am J Kidney Dis. 2004;43:433–43.
Maisonneuve P, Agodoa L, Gellert R, Stewart JH, Buccianti G, Lowenfels AB, et al. Distribution of primary renal diseases leading to end-stage renal failure in the United States, Europe, and Australia/New Zealand: results from an international comparative study. Am J Kidney Dis. 2000;35:157–65.
Hemmelgarn BR, Chou S, Wiebe N, Culleton BF, Manns BJ, Klarenbach S, et al. Differences in use of peritoneal dialysis and survival among East Asian, Indo Asian, and white ESRD patients in Canada. Am J Kidney Dis. 2006;48:964–71.
Brantsma AH, Atthobari J, Bakker SJ, de Zeeuw D, de Jong PE, Gansevoort RT. What predicts progression and regression of urinary albumin excretion in the nondiabetic population? J Am Soc Nephrol. 2007;18:637–45.
Voyaki SM, Staessen JA, Thijs L, Wang JG, Efstratopoulos AD, Birkenhager WH, et al. Follow-up of renal function in treated and untreated older patients with isolated systolic hypertension. Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. J Hypertens. 2001;19:511–9.
Acknowledgments
The authors would like to thank the staff of Ibaraki Health Service Association, especially Mr. Ryuji Yamashita and Dr. Iwao Yamaguchi. This study was supported in part by a Grant-in-Aid for Strategic Outcome Study project for chronic kidney disease and Research on the Positioning of Chronic Kidney Disease in Specific Health Check and Guidance in Japan from the Ministry of Health, Labor and Welfare of Japan.
Conflict of interest
None declared.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Nagai, K., Saito, C., Watanabe, F. et al. Annual incidence of persistent proteinuria in the general population from Ibaraki annual urinalysis study. Clin Exp Nephrol 17, 255–260 (2013). https://doi.org/10.1007/s10157-012-0692-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10157-012-0692-5