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Clinical and Experimental Nephrology
Published in: Clinical and Experimental Nephrology 4/2018

01-08-2018 | Original article

Glucosuria and all-cause mortality among general screening participants

Authors: Kunitoshi Iseki, Tsuneo Konta, Koichi Asahi, Kunihiro Yamagata, Shouichi Fujimoto, Kazuhiko Tsuruya, Ichiei Narita, Masato Kasahara, Yugo Shibagaki, Toshiki Moriyama, Masahide Kondo, Chiho Iseki, Tsuyoshi Watanabe, For the “Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check”

Published in: Clinical and Experimental Nephrology | Issue 4/2018

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Abstract

Background

Dipstick urine tests are used for general health screening in Japan, but how the test results (e.g., glucosuria) relate to mortality is unknown.

Methods

Subjects participated in a nationwide screening in 2008 in six districts in Japan. We identified those who might have died using the national database of death certificates from 2008 to 2012 (total registered ~ 6 million) and verified candidates with the regional National Health Insurance Agency and public health nurses. Diabetes mellitus (DM) was defined as HbA1c ≥ 6.5%, fasting blood glucose ≥ 126 mg/dl, or medicated for DM. Hazard ratio (HR) and 95% confidence interval (CI) were calculated by Cox proportional hazard analysis. Glucosuria was defined as dipstick ≥ 1 +.

Results

Among 209,060 subjects, we identified 2714 fatalities (median follow-up 3.57 years). Crude mortality rates were 1.2% for those without glucosuria and 3.4% for those with glucosuria. After adjusting for sex, age, body mass index, comorbidity (DM, hypertension, and dyslipidemia), history (stroke, heart disease, and kidney disease), and lifestyle (smoking, drinking, walking, and exercise), the HR (95% CI) for dipstick glucosuria was 1.475 (1.166–1.849, P < 0.001). DM subjects with glucosuria (N = 4655) had a higher HR [1.302 (1.044–1.613, P = 0.020)] than DM subjects without glucosuria (N = 20,245), and non-DM subjects with glucosuria (N = 470) had a higher HR [2.511 (1.539–3.833, P < 0.001)] than non-DM subjects without glucosuria (N = 183,690).

Conclusion

Dipstick glucosuria significantly affected mortality in Japanese community-based screening participants.
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Metadata
Title
Glucosuria and all-cause mortality among general screening participants
Authors
Kunitoshi Iseki
Tsuneo Konta
Koichi Asahi
Kunihiro Yamagata
Shouichi Fujimoto
Kazuhiko Tsuruya
Ichiei Narita
Masato Kasahara
Yugo Shibagaki
Toshiki Moriyama
Masahide Kondo
Chiho Iseki
Tsuyoshi Watanabe
For the “Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check”
Publication date
01-08-2018
Publisher
Springer Singapore
Published in
Clinical and Experimental Nephrology / Issue 4/2018
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-017-1528-0

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