Synergistic effect of proteinuria on dipstick hematuria-related decline in kidney function: The Japan Specific Health Checkups (J-SHC) Study

• Published in: Clinical and experimental nephrology 2023-12, Vol.27 (12), p.990-1000
• Main Authors: Tasaki, Hikari, Eriguchi, Masahiro, Yoshida, Hisako, Uemura, Takayuki, Fukata, Fumihiro, Nishimoto, Masatoshi, Kosugi, Takaaki, Matsui, Masaru, Samejima, Ken-ichi, Iseki, Kunitoshi, Asahi, Koichi, Yamagata, Kunihiro, Konta, Tsuneo, Fujimoto, Shouichi, Narita, Ichiei, Kasahara, Masato, Shibagaki, Yugo, Moriyama, Toshiki, Kondo, Masahide, Watanabe, Tsuyoshi, Tsuruya, Kazuhiko
• Format: Article
• Language: English
• Subjects: Analysis of covariance; Epidermal growth factor receptors; Hematuria; Kidneys; Medicine; Medicine & Public Health; Nephrology; Original Article; Proteinuria; Statistical analysis; Urology
• ISSN: 1342-1751; 1437-7799
• DOI: 10.1007/s10157-023-02390-6

Background The effect of isolated hematuria without proteinuria on kidney function decline, and the modification by the severity of proteinuria in general population are not fully elucidated. Methods Participants were included in the Japan Specific Health Checkups Study between 2008 and 2014. The exposure of interest was the frequency of dipstick hematuria during the observation. In each proteinuria frequency category (non-, occasional, persistent), hematuria-related decline in the eGFR rate was examined by analysis of covariance (ANCOVA). eGFR decline trajectories were also assessed using mixed-effects models. Results Among the 552,951 participants, 146,753 (26.5%) had hematuria, and 56,021 (10.1%) and 8,061 (1.5%) had occasional and persistent proteinuria, respectively. During the median follow-up of 3.0 years, annual change in eGFR decline in participants with hematuria was significantly faster than in those without hematuria (mean [95% confidence interval]: − 0.95 [− 0.98 to − 0.92] vs − 0.86 [− 0.87 to − 0.84] mL/min/1.73 m2/year; P