Trace Urine Albumin and Mortality: Kangbuk Samsung Health Study

Han, Eun Jin; Lee, Kyu Beck; Kim, Hyang; Hyun, Young Youl

doi:10.1159/000490474

Cited by 2 publications

(2 citation statements)

References 16 publications

(17 reference statements)

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“…Consistently, the incident of OP in R-TrP was approximately two times higher compared with that in T-TrP. Clinical studies in recent years [ 14 - 16 ] have shown that TrP may be a risk factor for metabolic syndrome and increased all-cause mortality. Therefore, not only OP, but also TrP, may have clinical significance for cardiometabolic conditions, including kidney disease.…”

Section: Discussionmentioning

confidence: 76%

Trace Proteinuria and the Incidence of Overt Proteinuria After Five Years: Results of the Kanagawa Investigation of the Total Checkup Data From the National Database-5 (KITCHEN-5)

2020

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Background Trace proteinuria (TrP), which is usually defined as ± by dipstick urinalysis, is considered as normal and of limited clinical significance. However, the relationship between TrP and overt proteinuria (OP) (≥ +1) in the future is unknown. Therefore, we investigated the association between TrP and future incidence of OP in a community-based cohort study. Methods TrP detected during the initial 2 years, which was classified into transient TrP (once/2 years) (T-TrP) and recurrent TrP (twice/2 years) (R-TrP); and the incidence of OP after 5 years were investigated in 292,257 general Japanese people aged 40 - 68 years who attended checkups. To determine TrP and OP, dipstick urinalysis was conducted with visual reading (VR) by medical staff or automated reading (AR) using a machine reader. Results Overall, T-TrP and R-TrP were observed in 24,782 (8.5%) and 3,767 (1.3%) subjects, respectively. Both types of TrP were prevalent in the detection with AR than VR. The prevalences of T-TrP and R-TrP showed J-shaped relationships against baseline body mass index (BMI), regardless of sex and BMI categories. The incident of OP after 5 years was larger (around 10%) in R-TrP than T-TrP (around 5%): approximately two times. Logistic regression analysis showed that T-TrP and R-TrP were significantly associated with OP, even after adjustment for relevant confounding factors including age, sex, and BMI (odds ratios (95% confidence intervals (CIs)): 2.77 (2.60 - 2.95) and 4.85 (4.34 - 5.43)), which were not largely altered when sub-analysis was conducted according to men and women, non-obesity and obesity, or AR and VR. In all analysis above, the odds ratios (95% CIs) of R-TrP for OP were higher than T-TrP. Conclusions Our findings suggest that TrP, particularly R-TrP, is substantially associated with the future incidence of OP, which may be independent of confounding factors and the methods detecting TrP.

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Section: Discussionmentioning

confidence: 76%

Trace Proteinuria and the Incidence of Overt Proteinuria After Five Years: Results of the Kanagawa Investigation of the Total Checkup Data From the National Database-5 (KITCHEN-5)

2020

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“…Therefore, the dipstick urine test would be helpful in clinical situations such as in EDs where routine tests require quick results or in medical environments where more accurate tests are not available. In addition, dipstick proteinuria has been reported as a predictor of mortality risk in the general population, and this prognostic significance was observed not only in higher degrees of proteinuria but also in trace proteinuria detected with the dipstick test [ 32 , 34 ]. Our data also showed that trace proteinuria was significantly associated with an increased risk of all-cause mortality.…”

Section: Discussionmentioning

confidence: 99%

Association of Dipstick Proteinuria with Long-Term Mortality among Patients with Hypertensive Crisis in the Emergency Department

Kim

Park

et al. 2022

JPM

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Proteinuria, frequently observed in hypertensive crisis, is a risk factor for cardiovascular and all-cause mortality in patients with hypertension. Here we investigated the association between proteinuria and all-cause mortality in patients with a hypertensive crisis in the emergency department (ED). This retrospective study included patients admitted to the ED of a tertiary referral center between 2016 and 2019 with hypertensive crisis (systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 110 mmHg); 3599 patients with an assay for proteinuria were included in this study. Proteinuria was defined as a trace or more protein on a urine dipstick test. Proteinuria was present in 1964 (54.6%) of 3599 patients. At 3 years, crude all-cause mortality rates were 10.8% for patients with negative proteinuria, 21.7% for those with trace proteinuria, 29.0% for those with proteinuria (1+), 32.0% for those with proteinuria (2+), and 35.4% for those with proteinuria (≥3+). After adjusting for age, sex, blood pressure, and comorbid conditions, the hazard ratio (95% confidence interval) for dipstick proteinuria was 1.91 (1.53–2.37) for those with trace proteinuria, 2.32 (1.85–2.91) for those with proteinuria (1+), 2.40 (1.86–3.10) for those with proteinuria (2+), and 2.40 (1.78–3.24) for those with proteinuria (≥3+) compared to the reference of negative proteinuria. In patients with hypertensive crisis, dipstick proteinuria was a significant predictor of all-cause mortality, and the risk of all-cause mortality increased in a dose-dependent manner according to its degree. Moreover, even trace proteinuria was associated with an increased risk of mortality. The dipstick urine test could be used as a simple and useful method for risk assessment of all-cause mortality in patients with hypertensive crisis.

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Trace Urine Albumin and Mortality: Kangbuk Samsung Health Study

Cited by 2 publications

References 16 publications

Trace Proteinuria and the Incidence of Overt Proteinuria After Five Years: Results of the Kanagawa Investigation of the Total Checkup Data From the National Database-5 (KITCHEN-5)

Trace Proteinuria and the Incidence of Overt Proteinuria After Five Years: Results of the Kanagawa Investigation of the Total Checkup Data From the National Database-5 (KITCHEN-5)

Association of Dipstick Proteinuria with Long-Term Mortality among Patients with Hypertensive Crisis in the Emergency Department

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