Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Dipstick Urine Protein, as a Predictor of Cardiovascular Mortality in Korean Men: Korea Medical Insurance Corporation Study

심혈관 사망 예측인자로써의 반정량적 단백뇨 검사: KMIC 연구

  • Ha, Kyoung-Soo (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Kim, Hyeon-Chang (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Kang, Dae-Ryong (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Nam, Chung-Mo (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Ahn, Song-Vogue (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Suh, Il (Department of Preventive Medicine, Yonsei University College of Medicine)
  • 하경수 (연세대학교 의과대학 예방의학교실) ;
  • 김현창 (연세대학교 의과대학 예방의학교실) ;
  • 강대룡 (연세대학교 의과대학 예방의학교실) ;
  • 남정모 (연세대학교 의과대학 예방의학교실) ;
  • 안성복 (연세대학교 의과대학 예방의학교실) ;
  • 서일 (연세대학교 의과대학 예방의학교실)
  • Published : 2006.09.30
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Abstract

Objectives: This study was to investigate if the dipstick proteinuria can predict cardiovascular mortality in a population of Korean men. Methods: We measured urine protein and other cardiovascular risk factors in 100059 Korean men, aged between 35-59 years in 1990 and 1992. Levels of proteinuria measured by dipstick method were trace or less, 1+, 2+, and 3+ or greater. The primary outcomes were deaths from all causes, cardiovascular disease, cancer, and others in a 12 year follow-up from 1993 to 2004. Results: The multivariate-adjusted relative risks (95% CI) for cardiovascular death according to the level of proteinuria (1+, 2+, 3+ and more) in 1990 examination were 2.18 (1.36-3.48), 2.55 (1.37-4.78), and 4.57 (2.16-9.66) respectively. The corresponding relative risks according to the level of proteinuria in 1992 examination were 2.49 (1.71-3.64), 2.64 (1.53-4.58), and 2.78 (1.15-6.73). The relative risks for cardiovascular death of men with proteinuria (1+ or greater) once and twice among the examinations were 2.18 (1.63-2.92) and 3.75 (2.27-6.18), compared with men without proteinuria in 1990 and 1992 examinations. Conclusions: Our results showed that dipstick proteinuria is associated with cardiovascular mortality in Korean men. Dipstick proteinuria could be a predictor for cardiovascular mortality.

Keywords

References

  1. Kannel WB, Stampfer MJ, Castelli WP, Verter J. The prognostic significance of proteinuria: the Framingham study. Am Heart J 1984; 108(5): 1347-1352 https://doi.org/10.1016/0002-8703(84)90763-4
  2. Grimm RH Jr, Svendsen KH, Kasiske B, Keane WF, Wahi MM. Proteinuria is a risk factor for mortality over 10 years of follow-up. MRFIT rsearch group. Multiple risk factor intervention trial. Kidney Int Suppl 1997; 63: S10-14
  3. Culleton BF, Larson MG, Parfrey PS, Kannel WB, Levy D. Proteinuria as a risk factor for cardiovascular disease and mortality in older people: A prospective study. Am J Med. 2000; 109(1): 1-8
  4. Valmadrid CT, Klein R, Moss SE, Klein BE. The risk of cardiovascular disease mortality associated with microalbuminuria and gross proteinuria in persons with older-onset diabetes mellitus. Arch Intern Med 2000; 160(8): 1093-1100 https://doi.org/10.1001/archinte.160.8.1093
  5. Gerstein HC, Mann JFE, Yi Q, Zimman B, Dinneen SFD, Hoogwerf B, Halle JP, Young J, Rashkow A, Joyce C, Nawaz S, Yusuf S. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA 2001; 286(4): 421-426 https://doi.org/10.1001/jama.286.4.421
  6. Cosentino F, Rubattu S, Savoia C, Venturelli V, Pagannonne E, Volpe M.J. Endothelial dysfunction and stroke. Cardiovasc Pharmacol 2001; 38(Suppl) 2: S75-78
  7. Roest M, Banga JD, Janssen WM, Grobbee DE, Sixma JJ, de Jong PE, de Zeeuw D, van Der Schouw YT. Excessive urinary albumin levels are associated with future cardiovascular mortality in postmenopausal women. Circulation 2001; 103(25): 3057-3061 https://doi.org/10.1161/hc2501.091353
  8. Tsioufis C, Dimitriadis K, Antoniadis D, Stefanadis C, Kallikazaros I. Inter-relationships of microalbuminuria with the other surrogates of the atherosclerotic cardiovascular disease in hypertensive subjects. Am J Hypertens 2004; 17:470-476 https://doi.org/10.1016/j.amjhyper.2004.02.008
  9. Tanihara S, Hayakawa T, Oki I, Nakamura Y, Sakata K, Okayama A, Fujita Y, Ueshima H; NIPPON DATA Research Group. Proteinuria is a prognostic marker for cardiovascular mortality: NIPPON DATA 80,1980-1999. J Epidemiol. 2005; 15(4): 146-153 https://doi.org/10.2188/jea.15.146
  10. Mogensen CE. Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes, N Engl J Med 1984; 310(6): 356-360 https://doi.org/10.1056/NEJM198402093100605
  11. Borch-Johnsen K, Andersen PK, Deckert T. The effect of proteinuria on relative mortality in type 1 (insulin-dependent) diabetes mellitus. Diobetotogia; 1985; 28(8): 590-596
  12. Borch- Johnsen K, Kreiner S. Proteinuria: value as predictor of cardiovascular mortality in insulin dependent diabetes mellitus. Br Med J 1987;294(6588): 1651-1654 https://doi.org/10.1136/bmj.294.6588.1651
  13. Nelson RG, Pettitt DJ, Carraher MJ, Baird HR, Knowler We. Effect of proteinuria on mortality in NIDDM. Diabetes. 1988; 37(11): 1499-1504 https://doi.org/10.2337/diabetes.37.11.1499
  14. Ryu SY, Oh JG, Lee CG, Kim KS. Relationship of serum uric acid to cardiovascular risk factors in Korean male workers. Korean J Prev Med. 2002; 35(3): 214-220 (Korean)
  15. Lim JS, Kim YJ, Chun BY, Lee DH, Kam S. The association between serum GGT level within normal range and risk factors of cardiovascular diseases. J Prev Med Public Health 2005; 38(2): 101-106 (Korean)
  16. Suh I, Jee SH, Kim HC, Nam CM, Kim IS, Appel LJ. Low serum cholesterol and haemorrhagic stroke in men: Korea medical insurance corporation study. lancet 2001; 357(9260): 922-925 https://doi.org/10.1016/S0140-6736(00)04213-6
  17. Jee SH, Boulware LE, Guallar E, Suh I, Appel LJ, Miller ER 3rd. Direct, progressive association of cardiovascular risk factors with incident proteinuria: results from the Korea medical insurance corporation (KMIC) study. Arch Intern Med 2005; 165(19): 2299-2304 https://doi.org/10.1001/archinte.165.19.2299
  18. James GP. Bee DE, Fuller JB. Proteinuria: accuracy an precision of laboratory diagnosis by dipstick analysis. Clin Chem. 1978; 24(11): 1934-1939
  19. Pugia MJ, Wallace JF, Lott JA, Sommer R, Luke KE, Shihabi ZK, Sheehan M, Bucksa JM. Albuminuria and proteinuria in hospitalized patients as measured by quantitative and dipstick methods. J Clin Lab Anal 2001; 15(5): 295-300 https://doi.org/10.1002/jcla.1040
  20. Kim YK, Kwon OH, Kim KD. Annual report on external quality assessment in clinical chemistry in Korea (1992). J Clin Pathol Qual Cont 1993; 15: 1-3
  21. National Institutes of Health. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda, Md: National Institutes of Health; NIH publication No. 04 5230,2004
  22. Pedersen LM, Milman N. Prevalence and prognostic significance of proteinuria in patients with lung cancer. Acta Oncol. 1996; 35(6): 691-695 https://doi.org/10.3109/02841869609084000
  23. Satoh A, Hanawa Y, Nakamura S. Clinical study of bladder cancer: Proteinuria as a predictor of recurrence and efficacy of intravesical bacille Calmette-Guerin therapy. Int J Urol. 2004; 11(7): 476-482 https://doi.org/10.1111/j.1442-2042.2004.00847.x
  24. Taniguchi K, Fujioka H, Torashima Y, Yamaguchi J, Izawa K, Kanematsu T. Rectal cancer with paraneoplastic nephropathy: Association of vascular endothelial growth factor. Dig Surg. 2004; 21(5-6): 455-457 https://doi.org/10.1159/000083474
  25. Kijima Y, Yoshinaka H, Owaki T, Nozaki T, Hamada T, Yasumoto Y, Aikou T. Breast cancer with nephrotic syndrome: report of two cases. Surg Today. 2004; 34(9): 755-759
  26. Khang YH, Hwang IA, Yun SC, Lee MS, Lee SI, Jo MW, Lee MJ. Census population vs. registration population: which population denominator should be used to calculate geographical mortality? J Prev Med Public Health. 2005; 38 (2): 147-153 (Korean)