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Trace proteinuria detected via dipstick test is associated with kidney function decline and new-onset overt proteinuria: the Japan Specific Health Checkups (J-SHC) Study

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Abstract

Background

Microalbuminuria is associated with mortality, cardiovascular disease, and end-stage kidney disease. The association between trace proteinuria (detected via dipstick test) and kidney outcomes is unclear.

Methods

This nationwide longitudinal study used data from the Japan Specific Health Checkups Study conducted during 2008–2014. The frequency of trace proteinuria (detected via dipstick test) during first two visits was used as an exposure variable (TrUP 0/2, no trace proteinuria; TrUP 1/2, detected once; TrUP 2/2, detected twice), and kidney outcomes were evaluated. The association between the frequency of trace proteinuria and incidence of 1.5-fold increase in serum creatinine levels and overt proteinuria was analyzed using Cox regression analysis. Trajectories of estimated glomerular filtration rate (eGFR) were compared using a mixed-effect model.

Results

Among 306,317 participants, 3188 and 17,461 developed a 1.5-fold increase in serum creatinine levels and new-onset overt proteinuria, respectively, during the median follow-up period of 36.2 months. The adjusted hazard ratio (HR) and 95% confidence interval (CI) for 1.5-fold increase in serum creatinine level in the TrUP 1/2 and TrUP 2/2 groups, compared to TrUP 0/2 group, were 1.23 (1.07–1.42) and 1.39 (1.01–1.92), respectively, and the adjusted HR (95% CI) for overt proteinuria were 2.94 (2.83–3.06) and 5.14 (4.80–5.51), respectively. The eGFR decline rates in the TrUP 1/2 and TrUP 2/2 groups were higher than that in the TrUP 0/2 group (p for interaction < 0.001).

Conclusions

Trace proteinuria (detected via dipstick test) was associated with subsequent kidney function decline and overt proteinuria in the general population.

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Data availability

The data used in this study are not available publicly.

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Acknowledgements

The authors acknowledge the contributions of the staff members who collected the data and instructed the participants with metabolic syndrome at screening centers in the following regions: Hokkaido, Yamagata, Miyagi, Fukushima, Tochigi, Ibaraki, Chiba, Saitama, Tokyo, Kanagawa, Niigata, Ishikawa, Fukui, Nagano, Gifu, Osaka, Hyogo, Okayama, Tokushima, Kochi, Fukuoka, Saga, Kumamoto, Oita, Miyazaki, and Okinawa.

We would like to thank Editage (www.editage.com) for English language editing.

Funding

This study was supported by the Health and Labor Sciences Research Grants for Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup from the Ministry of Health, Labor, and Welfare of Japan and a Grant-in-Aid for Research on Advanced Chronic Kidney Disease (REACH-J), Practical Research Project for Renal Disease from the Japan Agency for Medical Research and Development (AMED), and JSPS KAKENHI Grant Number JP18K11131.

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Authors and Affiliations

  1. Department of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan

    Takaaki Kosugi, Masahiro Eriguchi, Hiroyuki Tamaki, Takayuki Uemura, Hikari Tasaki, Riri Furuyama, Fumihiro Fukata, Masatoshi Nishimoto, Masaru Matsui, Ken-ichi Samejima & Kazuhiko Tsuruya

  2. Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Osaka, Japan

    Hisako Yoshida

  3. Steering Committee of The Japan Specific Health Checkups (J-SHC) Study, Fukushima, Japan

    Kunitoshi Iseki, Shouichi Fujimoto, Tsuneo Konta, Toshiki Moriyama, Kunihiro Yamagata, Ichiei Narita, Masato Kasahara, Yugo Shibagaki, Masahide Kondo, Koichi Asahi, Tsuyoshi Watanabe & Kazuhiko Tsuruya

Authors
  1. Takaaki Kosugi
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  2. Masahiro Eriguchi
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Contributions

Research idea and study design: TaK, ME, TU, HT, FF, MN, MM, KS, and KT; data acquisition: HY, KI, SF, TsK, TM, KY, IN, MKa, YS, MKo, KA, TW, and KT; data analysis/interpretation: TK, ME, and KT; statistical analysis: TK, ME, and KT; supervision or mentorship: ME and KT. Each author contributed important intellectual content during manuscript drafting or revision and accepted accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work were appropriately investigated and resolved.

Corresponding author

Correspondence to Masahiro Eriguchi.

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Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

All procedures involving human participants were conducted in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (Fukushima Medical University; IRB Approval Number #1485, #2771) and the 1964 Helsinki Declaration and its amendments. This study was conducted in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects enacted by the Ministry of Health, Labour, and Welfare of Japan [http://www.mhlw.go.jp/file/06-Seisakujouhou-10600000nDaijinkanboukouseikagakuka/0000069410.pdf].

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Kosugi, T., Eriguchi, M., Yoshida, H. et al. Trace proteinuria detected via dipstick test is associated with kidney function decline and new-onset overt proteinuria: the Japan Specific Health Checkups (J-SHC) Study. Clin Exp Nephrol 27, 801–808 (2023). https://doi.org/10.1007/s10157-023-02369-3

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  • DOI: https://doi.org/10.1007/s10157-023-02369-3

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