Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1 Ten-oudai, Tsukuba, Ibaraki, 305-8575, Japan.
Clin Exp Nephrol. 2013 Apr;17(2):255-60. doi: 10.1007/s10157-012-0692-5. Epub 2012 Sep 13.
For a definitive diagnosis of chronic kidney disease, at least 2 consecutive positive results of proteinuria with an interval of >3 months are required. However, most previous reports were based on single-screening data.
The subjects in this study were participants in an annual health examination held in Ibaraki, Japan, between 1993 and 2003. The follow-up duration with serial urinalysis for 3 years of patients who were negative for proteinuria in the initial year was 330,614 person-years in males and 687,381 person-years in females among 81,854 male and 155,256 female subjects. We evaluated the incidence and risk factor for the incidence of proteinuria and persistent proteinuria.
The annual incidence of proteinuria and persistent proteinuria was 1.31 and 0.33 % in males and 0.68 and 0.14 % in females. Among the subjects without hypertension and diabetes, the annual incidence was 0.81 and 0.16 % in males and 0.37 and 0.06 % in females, respectively. Risk analysis indicated that hypertension in males [hazard ratio (HR) 2.052] and females (2.477), diabetes in males (3.532) and females (3.534) and reduced renal function in males (3.097) and females (2.827) were significant positive risks for development of persistent proteinuria.
By annual urinalysis screening of the general population, 1 out of 303 male subjects and 1 out of 725 female subjects developed persistent proteinuria every year. Subjects with diabetes, hypertension and reduced renal function had a 2 or 3 times higher risk for the incidence of persistent proteinuria in both males and females.
为了明确慢性肾脏病的诊断，至少需要 2 次连续阳性的蛋白尿结果，且两次结果的间隔时间需大于 3 个月。然而，大多数既往的报告均基于单次筛查数据。
本研究的对象是参加了 1993 年至 2003 年期间在日本茨城县进行的年度健康检查的参与者。在初始年度尿蛋白阴性的患者中，连续进行 3 年尿蛋白筛查的随访时间为男性 330614 人年，女性 687381 人年，其中男性有 81854 人，女性有 155256 人。我们评估了蛋白尿和持续性蛋白尿的发生率及发病的危险因素。
男性蛋白尿和持续性蛋白尿的年发生率分别为 1.31%和 0.33%，女性分别为 0.68%和 0.14%。在无高血压和糖尿病的患者中，男性的年发生率分别为 0.81%和 0.16%，女性分别为 0.37%和 0.06%。风险分析表明，男性高血压（HR 2.052）和女性高血压（2.477）、男性糖尿病（3.532）和女性糖尿病（3.534）以及男性肾功能减退（3.097）和女性肾功能减退（2.827）是持续性蛋白尿发展的显著正风险因素。
通过对普通人群进行年度尿检筛查，每年有 1/303 名男性和 1/725 名女性发展为持续性蛋白尿。男性和女性中，患有糖尿病、高血压和肾功能减退的患者发生持续性蛋白尿的风险增加 2 至 3 倍。
