Cause-specific mortality in the general population with transient dipstick-proteinuria


Autoři: Kei Nagai aff001;  Kunihiro Yamagata aff001;  Kunitoshi Iseki aff002;  Toshiki Moriyama aff002;  Kazuhiko Tsuruya aff002;  Shouichi Fujimoto aff002;  Ichiei Narita aff002;  Tsuneo Konta aff002;  Masahide Kondo aff001;  Masato Kasahara aff002;  Yugo Shibagaki aff002;  Koichi Asahi aff002;  Tsuyoshi Watanabe aff002
Působiště autorů: University of Tsukuba, Tsukuba, Ibaraki, Japan aff001;  The Steering Committee for “Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkups”, Tsukuba, Ibaraki, Japan aff002;  Okinawa Heart and Renal Association, Okinawa, Japan aff003;  Health Care Center, Osaka University, Suita, Japan aff004;  Nara Medical University, Nara, Japan aff005;  University of Miyazaki, Miyazaki, Japan aff006;  Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan aff007;  Yamagata University Graduate School of Medical Science, Yamagata, Japan aff008;  Institute for Clinical and Translational Science, Nara Medical University Hospital, Nara, Japan aff009;  St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan aff010;  Iwate Medical University, Morioka, Japan aff011;  Fukushima Rosai Hospital, Iwaki, Japan aff012
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223005

Souhrn

Recently, changes in urinary albumin and in GFR have been recognized as risk factors for the development of end-stage kidney disease and mortality. Though most clinical epidemiology studies of chronic kidney disease (CKD) used renal function and proteinuria at baseline alone, definitive diagnosis of CKD with multiple measurements intensifies the differences in the risk for mortality between the CKD and non-CKD populations. We hypothesized that a transient diagnosis of proteinuria and reduced renal function each indicate a significantly higher mortality compared to definitive non-CKD as the negative control and lower mortality compared with definitive CKD as the positive control. The present longitudinal study evaluated a general-population cohort of 338,094 persons who received annual health checkups, with a median 4.3-year study period. There were 2,481 deaths, including 510 CVD deaths (20.6%) and 1,328 cancer deaths (53.5%), and mortality risk was evaluated for transient proteinuria and for transiently reduced renal function. The hazard ratios (HRs) for all-cause mortality and cancer mortality were not significant, but that for cardiovascular mortality was significantly higher for transient proteinuria (HR, 1.94 [95% confidence interval, 1.27–2.96] in men and 2.78 [1.50–5.16] in women). On the other hand, transiently reduced renal function was not significant for either cardiovascular mortality risk or cancer mortality risk. We surmise that this is the first study of the mortality risk of transient dipstick proteinuria in a large general-population cohort with cause-specific death registration. Transiently positive proteinuria appears to be a significant risk specifically for cardiovascular mortality compared with definitely negative for proteinuria.

Klíčová slova:

Antihypertensive drugs – Blood pressure – Cardiovascular diseases – Death rates – Glomerular filtration rate – Chronic kidney disease – Lipoproteins – Proteinuria


Zdroje

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PLOS One


2019 Číslo 10

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