Clinical Research Support Center, Tomishiro Central Hospital, Tomigusuku, Okinawa, Japan.
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Fukushima, Japan.
Nephrol Dial Transplant. 2018 May 1;33(5):825-832. doi: 10.1093/ndt/gfx213.
Dipstick urine tests are used for general health screening in Japan. The effects of this screening on mortality have not been examined, especially with regard to hematuria.
Subjects were those who participated in the 2008 Tokutei-Kenshin (nationwide specific health check and guidance program) in six districts in Japan. Using the national database of death certificates from 2008 to 2012, we identified subjects who might have died. We verified the candidates in collaboration with the regional National Health Insurance agency and public health nurses. Data were released to the research team supported by the Ministry of Health, Labor, and Welfare of Japan. Dipstick results of 1+ and higher were defined as hematuria (+). Hazard ratio (HR) [95% confidence interval (CI)] was calculated using the Cox proportional hazard analysis.
Among 112 115 subjects, we identified that 1290 had died by the end of 2012. In hematuria (-) subjects, the crude mortality rates were 1.2% (1.8% in men, 0.7% in women), whereas in hematuria (+) subjects, they were 1.1% (2.9% in men, 0.7% in women). After adjusting for age, body mass index, estimated glomerular filtration rate, proteinuria, comorbid condition (diabetes mellitus, hypertension and dyslipidemia), past history (stroke, heart disease and kidney disease) and lifestyle (smoking, drinking, walking and exercise), the HR (95% CI) for dipstick hematuria (+) in men was 1.464 (1.147-1.846; P = 0.003), whereas that for hematuria (-) was 0.820 (0.617-1.073; P = 0.151).
Dipstick hematuria is significantly associated with mortality in men among Japanese community-based screening participants.
在日本，尿试纸检测被用于一般健康筛查。这种筛查对死亡率的影响尚未得到检验，尤其是在血尿方面。
研究对象为参加了日本六个地区 2008 年特命健康检查和指导计划的人员。我们利用 2008 年至 2012 年全国死亡证明数据库，确定了可能已经死亡的研究对象。我们与地区国民健康保险机构和公共卫生护士合作对候选人进行了核实。数据由日本厚生劳动省支持的研究团队发布。将尿试纸结果为 1+及以上定义为血尿（+）。使用 Cox 比例风险分析计算风险比（HR）[95%置信区间（CI）]。
在 112115 名受试者中，我们发现到 2012 年底有 1290 人死亡。在血尿（-）受试者中，粗死亡率为 1.2%（男性为 1.8%，女性为 0.7%），而在血尿（+）受试者中，死亡率为 1.1%（男性为 2.9%，女性为 0.7%）。在调整年龄、体重指数、估算肾小球滤过率、蛋白尿、合并症（糖尿病、高血压和血脂异常）、既往病史（中风、心脏病和肾病）和生活方式（吸烟、饮酒、散步和运动）后，男性尿试纸血尿（+）的 HR（95%CI）为 1.464（1.147-1.846；P=0.003），而血尿（-）的 HR 为 0.820（0.617-1.073；P=0.151）。
在日本社区筛查参与者中，尿试纸血尿与男性死亡率显著相关。
