2011 Volume 25 Issue 5 Pages 811-817
Objective: Most chronic kidney disease (CKD) patients do not have proteinuria. We investigated risk factors of CKD without proteinuria and CKD progression in cases we had encountered.
Methods: Among 8,357 persons of 20 years and older who were examined at our health check-up center from 2002 onwards, we extracted those who had an eGFR (estimated glomerular filtration rate) of less than 60 mL/min/1.73m2 and conducted multivariate logistic regression analysis regarding the risk factors of sex, age, urine tests, uric acid, BMI, hypertension, hyperlipidemia, diabetes and smoking. We examined the course of eGFR in CKD subjects without proteinuria for whom 3-5 years of follow-up was possible.
Results: Examinees of over 60 years at stage 3 CKD accounted for 15.76% of the total. Those with an eGFR of 50 or over but less than 60 accounted for 86% and those negative for proteinuria 86%. The risk factors for stage 3 CKD stage subjects overall in decreasing order of precedence were age, hyperuricemia, proteinuria, hypertension, and sex while those for CKD subjects without proteinuria in decreasing order were age, hyperuricemia, and hypertension. In 3-5 years (average 4.32 years) of follow-up, no significant decrease in eGFR was observed in subjects without proteinuria.
Conclusion: 86% of stage stage 3 CKD cases discovered in health check-ups, have an eGFR of 50 mL/min/1.73m2 or above, the criterion for referral of patients for specialist examinations, and absence of proteinuria. Hyperuricemia is an important risk factor (odds ratio: 3.191) for CKD without proteinuria and interventions are considered necessary when it is present. We felt that proteinuria should be included as a stratified risk factor for CKD.
