2019 Volume 33 Issue 5 Pages 701-707
Objective: To effectively implement health guidance for prevention of chronic kidney disease (CKD) onset and progression, we examined changes in albumin in urine over a period of 5 years in subjects who underwent and had normal baseline urinary albumin level (<30 mg/g・Cr). Factors related to changes in level were examined.
Methods: Of 9,694 individuals who underwent a medical examination in 2009 and then 5 years later in 2014, we enrolled 8,386 (males 4,322, females 4,064; average age 50.9 ± 9.6 years) with normoalbuminuria in 2009, after excluding subjects with diabetes mellitus or nephritis. In 2014, we examined changes in urinary albumin level relative to the baseline level as well as related factors.
Results: We found that 5.04% of the subjects with normoalbuminuria in 2009 shifted microalbuminuria or macroalbuminuria in 2014, of whom 86.3% had urinary albumin levels lower than 100 mg/g・Cr. Factors associated with the at shift were aging as well as higher urinary albumin level, greater waist circumference, hypertension, low HDL-C, hypoalbuminemia, greater BMI in 2009. As for lifestyle factors, smoking, and consumption of protein-rich foods were associated with the change.
Discussion: Among factors shown to be related to the transition to microalbuminuria or macroalbuminuria, we consider that those of metabolic syndrome other than age can be addressed by interventions to improve blood pressure, obesity and dyslipidemia as well as smoking cessation and improved dietary habits. For patients with such associated factors, health guidance with emphasis on the possibility of progression to CKD is important.
