In a non-diabetic Japanese population, the combination of macroalbuminuria and increased urine beta 2-microglobulin predicts a decline of renal function: the Takahata study

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2009-03, Vol.24 (3), p.841-847
• Main Authors: Ikeda, Ami, Konta, Tsuneo, Takasaki, Satoshi, Hao, Zhimei, Suzuki, Kazuko, Sato, Hitoshi, Shibata, Yoko, Takeishi, Yasuchika, Kato, Takeo, Kawata, Sumio, Kubota, Isao
• Format: Article
• Language: English
• Subjects: Adult; Aged; albuminuria; Albuminuria - complications; Albuminuria - physiopathology; Albuminuria - urine; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Asian Continental Ancestry Group; Associated diseases and complications; beta 2-microglobulin; beta 2-Microglobulin - urine; Biological and medical sciences; Cohort Studies; Creatinine - urine; Diabetes. Impaired glucose tolerance; Emergency and intensive care: renal failure. Dialysis management; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; general population; Glomerular Filtration Rate; Humans; Intensive care medicine; Japan; Male; Medical sciences; Middle Aged; Predictive Value of Tests; renal insufficiency; Renal Insufficiency - epidemiology; Renal Insufficiency - pathology; Renal Insufficiency - urine; Risk Factors
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfn591

Background. Glomerular and tubular damage are important factors in the development of renal insufficiency. However, the interaction of these factors is largely unknown in the non-diabetic Japanese population. To clarify the relationship between renal insufficiency and both glomerular and tubular damage, we conducted a community-based study using albuminuria and urine beta 2-microglobulin as markers of glomerular and tubular damages, respecti- vely. Methods. Subjects of this study were 2816 non-diabetic individuals >40 years old in Takahata, Japan. The urine albumin–creatinine ratio (UACR) and urine beta 2-microglobulin–creatinine ratio (UBCR) were assessed from single spot urine. The glomerular filtration rate (eGFR) was estimated using the abbreviated MDRD equation with a Japanese coefficient. Results. The prevalence of albuminuria (UACR >20 mg/ g in men and >30 mg/g in women), increased UBCR (>300 μg/g) and renal insufficiency (eGFR 200 mg/g in men and >300 mg/g in women) and increased UBCR. No urinary abnormalities were observed in 71.7% of the 611 subjects with renal insufficiency, and were more common in young, women and the non-hypertensive population. The 1-year decline of eGFR was greatest in subjects with an overlap of macroalbuminuria and increased UBCR. Conclusions. This study indicated that only a small part of renal insufficiency accompanied increased urine albumin or beta 2-microglobulin in the non-diabetic Japanese population. The combination of macroalbuminuria and increased urine beta 2-microglobulin might predict faster renal deterioration.