Abstract
BackgroundAlthough lower estimated glomerular filtration rate (eGFR) and higher proteinuria are high risks for mortality and kidney outcomes, the prognosis of chronic kidney disease (CKD) in patients with normal-range proteinuria remains unclear.MethodsIn this prospective cohort study, 1138 newly visiting stage G2–G5 CKD patients were stratified into normal-range and abnormal-range proteinuria groups. Study endpoints were CKD progression (>50% eGFR loss or initiation of dialysis), cardiovascular events, and all-cause death.ResultsIn total, 927 patients who were followed for >6 months were included in the analysis. The mean age was 67 years, and 70.2% were male. During a median follow-up of 35 months, CKD progression, cardiovascular events, and mortality were observed in 223, 110, and 55 patients, respectively. Patients with normal-range proteinuria had a significantly lower risk for CKD progression (hazard ratio, 0.20; 95% confidence interval, 0.10–0.38) than those with abnormal-proteinuria by multivariate Cox proportional hazard analysis. We also analyzed patients with normal-range proteinuria (n = 351). Nephrosclerosis was the most frequent cause of CKD among all patients with normal-range proteinuria (59.7%). During a median follow-up of 36 months, CKD progression, cardiovascular events, and mortality were observed in 10, 28, and 18 patients, respectively. The Kaplan–Meyer analysis demonstrated that the risks of CKD progression and cardiovascular events were not significantly different among CKD stages, whereas the risk of death was significantly higher in patients with advanced-stage CKD. Multivariate Cox proportional hazard analysis showed that the risk of three endpoints did not significantly differ among CKD stages.ConclusionNewly visiting CKD patients with normal-range proteinuria, who tend to be overlooked during health checkups did not exhibit a decrease in kidney function even in advanced CKD stages under specialized nephrology care.
Highlights
Higher levels of albuminuria are widely demonstrated to precede and predict a faster rate of renal functional decline and to be associated with increased risk of end-stage kidney disease (ESKD), both in general population and in those with various pathophysiologic conditions such as diabetes, hypertension, and primary glomerular diseases [1]
Multivariate Cox proportional hazard analysis showed that the risk of three endpoints did not significantly differ among chronic kidney disease (CKD) stages
Visiting CKD patients with normal-range proteinuria, who tend to be overlooked during health checkups did not exhibit a decrease in kidney function even in advanced CKD stages under specialized nephrology care
Summary
Higher levels of albuminuria are widely demonstrated to precede and predict a faster rate of renal functional decline and to be associated with increased risk of end-stage kidney disease (ESKD), both in general population and in those with various pathophysiologic conditions such as diabetes, hypertension, and primary glomerular diseases [1]. In a study including data from 574,024 participants (240,594 males and 333,430 females) over the age of 20 years that were from the Japanese general adult population, prevalence of patients with a eGFR of less than 60 ml/min/1.73 m2 and a negative proteinuria by dipstick urinary test was about 10%; such patients will be overlooked by only using dipstick test [5] Lower eGFR and higher proteinuria indicate a high risk for mortality and worse kidney outcomes, the prognosis of CKD patients with normal-range proteinuria who may be overlooked during a health checkup, remains uncertain. Lower estimated glomerular filtration rate (eGFR) and higher proteinuria are high risks for mortality and kidney outcomes, the prognosis of chronic kidney disease (CKD) in patients with normal-range proteinuria remains unclear
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
