Healthcare providers have long recognized proteinuria – or the presence of excess protein in urine – as a hallmark of chronic kidney disease. This condition has also been closely associated with hypertension and diabetes. However, a study in PLoS One suggests that proteinuria could also lead to a higher risk of all-cause death [1].
The 2018 study examined medical records for 17 million adults covered by the National Health Insurance System in South Korea. These adults received health examinations that included dipstick urinalysis conducted with urine protein test strips. The authors wanted to determine if there was a link between dipstick proteinuria and all-cause mortality. This article unpacks the findings of their ground-breaking study.
Study Population
The authors started their investigation by gathering data from the Health Insurance Review and Assessment database. Approximately 31 million Korean adults aged 20 and older underwent health examinations between 2005 and 2008. The authors narrowed their study population by focusing on the 17.3 million adults with complete records who only received a single exam during this period.
Here are the baseline characteristics of this study population:
- 53% men
- Median age: 46 years
- 33% were former or current smokers
- 53% didn’t consume alcohol
- 54% didn’t exercise at all
- 26% had hypertension
- 14% had dyslipidemia
- 8% had diabetes
Methodology
The authors used the results of single dipstick urinalysis to determine which participants had proteinuria during their medical examination. The patients provided urine samples early in the morning after fasting the night before their appointment.
Healthcare professionals used urine test strips to detect and measure protein in their urine. They quantified proteinuria based on this scale: negative, trace, 1+, 2+, 3+, or 4+. Patients who tested negative had no protein in their urine, while a 4+ score indicates the highest level of proteinuria.
The participants were monitored from the beginning of their first annual exam until December 31, 2015, or their death. Approximately 725,000 all-cause deaths occurred during this period.
Uncovering the Link Between Proteinuria and Mortality
The study reveals a significant association between people with proteinuria and all-cause mortality. Patients with trace proteinuria had a 21% higher risk of mortality than people with negative proteinuria, and the risk for people with 1+ proteinuria was 46% higher. In addition, people with 3+ and 4+ proteinuria had more than twice the mortality risk.
Participants without obesity and with 1+ or higher proteinuria had the highest risk of all-cause mortality. Additionally, the risk of all-cause mortality increased by more than two-fold for people with metabolic diseases who had 1+ or higher proteinuria.
Detect Proteinuria With At-Home Urinalysis Test Strips
Proteinuria can be a sign of many health conditions and even, as this study suggests, be a predictor for all-cause mortality. Stay proactive with Diagnox protein in urine test strips. This affordable and simple test allows you to detect the presence of protein in urine so you can perform at-home screenings.
