Daisuke Uchida1, Hiroo Kawarazaki2, Yugo Shibagaki2, Takashi Yasuda2, Naoto Tominaga2, Tsuyoshi Watanabe3, Koichi Asahi3, Kunitoshi Iseki4, Chiho Iseki4, Kazuhiko Tsuruya5, Kunihiro Yamagata6, Toshiki Moriyama7, Ichiei Narita8, Shoichi Fujimoto9, Tsuneo Konta10, Masahide Kondo11, Masato Kasahara12, Kenjiro Kimura2. 1. Department of Nephrology and Hypertension, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan. uchidadaiske@gmail.com. 2. Department of Nephrology and Hypertension, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan. 3. Division of Nephrology and Hypertension, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan. 4. Dialysis Unit, University Hospital of The Ryukyus, 207 Uehara, Okinawa, Nishihara, 903-0215, Japan. 5. Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, Higashi-ku, 812-8582, Japan. 6. Department of Nephrology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan. 7. Health Care Center, Osaka University, 1-17 Machikaneyama-cho, Osaka, Toyonaka, 560-0043, Japan. 8. Division of Clinical Nephrology and Rheumatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Chuo-ku Niigata, Niigata, 951-8510, Japan. 9. Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan. 10. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan. 11. Department of Health Care Policy and Management, Graduate School of Comprehensive Sciences, University of Tsukuba, 1-1-1 Tennoudai, Ibaraki, 305-8577, Tsukuba, Japan. 12. Department of EBM Research, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.
Abstract
BACKGROUND: It is not known if urine dipstick alone can identify chronic kidney disease (CKD) in the general Japanese population. METHODS: We designed a cross-sectional study using data obtained in 2008 from a nationwide community-based health examination program for adults aged 40-74. The data consisted of blood tests, urine tests and questionnaire related to metabolic disorders. Those who had both serum creatinine measured and urine dipstick tested were analyzed. RESULTS: Data were obtained from 538,846 people with a mean age of 62.8 years, consisting of 41.6 % males. Our study showed that 14.4 % had an eGFR below 60 mL/min/1.73 m(2), 5.2 % had proteinuria and 18.1 % had CKD. Within the population with CKD, non-proteinuric CKD accounted for 71.4 %. The proportion of non-proteinuric CKD was highest in stage G3a (91.8 %) followed by G3b (77.0 %) disease, and was greater in the more elderly and in females. The proportion of non-proteinuric CKD was 47.9 % in diabetes mellitus, 69.3 % in dyslipidemia, 66.8 % in hypertension and 57.1 % in metabolic syndrome. Furthermore, non-proteinuric CKD accounted for 78.1 % of the population without these lifestyle diseases, suggesting that even in the population without apparent risk, CKD is still prevalent and can be missed when urine dipstick is the only screening method used. CONCLUSIONS: This study showed that a considerable population of CKD might be overlooked when only dipstick proteinuria is assessed for CKD screening. Hence, we strongly recommend that both urinalysis and serum creatinine measurement should be a part of the nationwide CKD screening system.
BACKGROUND: It is not known if urine dipstick alone can identify chronic kidney disease (CKD) in the general Japanese population. METHODS: We designed a cross-sectional study using data obtained in 2008 from a nationwide community-based health examination program for adults aged 40-74. The data consisted of blood tests, urine tests and questionnaire related to metabolic disorders. Those who had both serum creatinine measured and urine dipstick tested were analyzed. RESULTS: Data were obtained from 538,846 people with a mean age of 62.8 years, consisting of 41.6 % males. Our study showed that 14.4 % had an eGFR below 60 mL/min/1.73 m(2), 5.2 % had proteinuria and 18.1 % had CKD. Within the population with CKD, non-proteinuric CKD accounted for 71.4 %. The proportion of non-proteinuric CKD was highest in stage G3a (91.8 %) followed by G3b (77.0 %) disease, and was greater in the more elderly and in females. The proportion of non-proteinuric CKD was 47.9 % in diabetes mellitus, 69.3 % in dyslipidemia, 66.8 % in hypertension and 57.1 % in metabolic syndrome. Furthermore, non-proteinuric CKD accounted for 78.1 % of the population without these lifestyle diseases, suggesting that even in the population without apparent risk, CKD is still prevalent and can be missed when urine dipstick is the only screening method used. CONCLUSIONS: This study showed that a considerable population of CKD might be overlooked when only dipstick proteinuria is assessed for CKD screening. Hence, we strongly recommend that both urinalysis and serum creatinine measurement should be a part of the nationwide CKD screening system.
Entities:
Keywords:
Chronic kidney disease; Screening; Urine dipstick test
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