Comparison of the predictive ability of albuminuria and dipstick proteinuria for mortality in the Japanese population: the Yamagata (Takahata) study

Hiroko Sato, Tsuneo Konta, Kazunobu Ichikawa, Natsuko Suzuki, Asami Kabasawa, Kazuko Suzuki, Atsushi Hirayama, Yoko Shibata, Tetsu Watanabe, Takeo Kato, Yoshiyuki Ueno, Takamasa Kayama, Isao Kubota

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Albuminuria and proteinuria are known risk factors for premature death. This study compared the ability of albuminuria and proteinuria to predict mortality in a community-based population. Methods: We evaluated the urinary albumin creatinine ratio (ACR) and proteinuria by dipstick at a baseline survey and examined the association between the 7-year mortality and three categories (albuminuria [ACR ≥ 30 mg/g], trace proteinuria, and ≥[1+] proteinuria) in 3446 Japanese subjects at a local health check. Results: Albuminuria, ≥trace proteinuria, and ≥(1+) proteinuria were identified in 514 (14.9 %), 290 (8.4 %), and 151 (4.4 %) subjects, respectively. There were 138 deaths during the follow-up period, including 41 cardiovascular deaths. A Kaplan–Meier analysis showed that all-cause mortality significantly increased along with the increase in ACR and proteinuria levels (log-rank P < 0.01). The mortality rate (deaths per 1000 person-year) was higher in subjects with albuminuria (12.8), ≥trace proteinuria (12.6), and ≥(1+) proteinuria (16.2) than in all subjects (6.9). A Cox proportional hazard model analysis showed that all three categories were significant predictors of all-cause mortality in the unadjusted model, although after adjustment for possible confounders, a significant association was observed only with albuminuria. Albuminuria, but not proteinuria, was a significant predictor of cardiovascular mortality in both the unadjusted and adjusted models. Conclusion: Albuminuria had a high prevalence and was strongly associated with mortality, as compared with proteinuria by dipstick, suggesting that albuminuria might be a superior predictor of poor prognosis in the Japanese population.

Original languageEnglish
Pages (from-to)611-617
Number of pages7
JournalClinical and experimental nephrology
Volume20
Issue number4
DOIs
Publication statusPublished - 2016 Aug 1

Keywords

  • Albuminuria
  • Cohort
  • Mortality
  • Population
  • Proteinuria

ASJC Scopus subject areas

  • Physiology
  • Nephrology
  • Physiology (medical)

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