普通人群中的试纸法蛋白尿与全因死亡率
Dipstick proteinuria and all-cause mortality among the general population.
作者信息
Iseki Kunitoshi, Konta Tsuneo, Asahi Koichi, Yamagata Kunihiro, Fujimoto Shouichi, Tsuruya Kazuhiko, Narita Ichiei, Kasahara Masato, Shibagaki Yugo, Moriyama Toshiki, Kondo Masahide, Iseki Chiho, Watanabe Tsuyoshi
机构信息
Clinical Research Support Center, Tomishiro Central Hospital, Ueda 25, Tomigusuku, Okinawa, 901-0243, 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.
出版信息
Clin Exp Nephrol. 2018 Dec;22(6):1331-1340. doi: 10.1007/s10157-018-1587-x. Epub 2018 Jun 5.
BACKGROUND
Dipstick proteinuria, but not albuminuria, is used for general health screening in Japan. How the results of dipstick proteinuria tests correlate with mortality and, however, is not known.
METHODS
Subjects were participants of the 2008 Tokutei-Kenshin (Specific Health Check and Guidance program) in six districts in Japan. On the basis of the national database of death certificates from 2008 to 2012, we used a personal identifier in two computer registries to identify participants who might have died. The hazard ratio (95% confidence interval, CI) was calculated by Cox-proportional hazard analysis.
RESULTS
Among a total of 140,761 subjects, we identified 1641 mortalities that occurred by the end of 2012. The crude mortality rates were 1.1% for subjects who were proteinuria (-), 1.5% for those with proteinuria (+/-), 2.0% for those with proteinuria (1+), 3.5% for those with proteinuria (2+), and 3.7% for those with proteinuria (≥ 3+). After adjusting for sex, age, body mass index, estimated glomerular filtration rate, comorbid condition, past history, and lifestyle, the hazard ratio (95% CI) for dipstick proteinuria was 1.262 (1.079-1.467) for those with proteinuria (+/-), 1.437 (1.168-1.748) for those with proteinuria (1+), 2.201 (1.688-2.867) for those with proteinuria (2+), and 2.222 (1.418-3.301) for those with proteinuria (≥ 3+) compared with the reference of proteinuria (-).
CONCLUSION
Dipstick proteinuria is an independent predictor of death among Japanese community-based screening participants.
背景
在日本，试纸法蛋白尿检测用于一般健康筛查，但不包括白蛋白尿检测。然而，试纸法蛋白尿检测结果与死亡率之间的相关性尚不清楚。
方法
研究对象为日本六个地区2008年特定健康检查与指导项目（Tokutei-Kenshin）的参与者。基于2008年至2012年国家死亡证明数据库，我们在两个计算机登记处使用个人识别码来识别可能已经死亡的参与者。通过Cox比例风险分析计算风险比（95%置信区间，CI）。
结果
在总共140,761名研究对象中，我们确定到2012年底有1641人死亡。蛋白尿（-）的研究对象粗死亡率为1.1%，蛋白尿（+/-）的为1.5%，蛋白尿（1+）的为2.0%，蛋白尿（2+）的为3.5%，蛋白尿（≥ 3+）的为3.7%。在对性别、年龄、体重指数、估计肾小球滤过率、合并症、既往史和生活方式进行校正后，与蛋白尿（-）的参考组相比，蛋白尿（+/-）者的风险比（95%CI）为1.262（1.079 - 1.467），蛋白尿（1+）者为1.437（1.168 - 1.748），蛋白尿（2+）者为2.201（1.688 - 2.867），蛋白尿（≥ 3+）者为2.222（1.418 - 3.301）。
结论
在日本社区筛查参与者中，试纸法蛋白尿是死亡的独立预测因素。
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