RISK FACTORS FOR PROTEINURIA AND CHRONIC KIDNEY DISEASE IN INDIVIDUALS UNDERGOING ROUTINE HEALTH EXAMINATIONS: A MULTICENTER CROSS-SECTIONAL ANALYSIS

 

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https://storage.unitedwebnetwork.com/files/1099/3601afd544582f42735a80da7ae028f7.pdf
RISK FACTORS FOR PROTEINURIA AND CHRONIC KIDNEY DISEASE IN INDIVIDUALS UNDERGOING ROUTINE HEALTH EXAMINATIONS: A MULTICENTER CROSS-SECTIONAL ANALYSIS

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Dina
Nilasari
Dina Nilasari nilasari.dina@yahoo.co.uk Siloam Hospitals Group Clinical Research Department Jakarta Indonesia *
Regina Anjani reginaanjani@rocketmail.com Siloam Hospitals Group Clinical Research Department Jakarta Indonesia -
William Ricardo williamricardowardojo@gmail.com Siloam Hospitals Group Clinical Research Department Jakarta Indonesia -
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Chronic Kidney Disease (CKD) is a significant global public health concern, often presenting asymptomatically in its early stages. Proteinuria, defined as the presence of excessive protein in the urine, is a key early indicator of CKD and an independent risk factor for cardiovascular events. Identifying these risk factors in apparently healthy populations, such as those undergoing routine Medical Check-Ups (MCU), is critical for early detection and intervention strategies. This study aimed to determine the prevalence of, and identify the independent risk factors for, both proteinuria and CKD in a large, multicenter population of asymptomatic Indonesian adults undergoing MCU.

A multicenter, cross-sectional study was conducted on 58,546 adults who underwent routine MCU at Indonesia’s largest hospital chain, comprising 42 hospitals. Proteinuria was defined as detected protein in urine via a dipstick test. CKD was defined as an estimated Glomerular Filtration Rate (eGFR) of less than 60 mL/min/1.73 m2, calculated using the 2021 CKD-EPI formula. The primary variables analyzed were age, gender, hypertension, Body Mass Index (BMI), diabetes mellitus, and total cholesterol. Binary logistic regression was the main statistical method used to identify independent predictors.

The overall prevalence of dipstick-positive proteinuria was 5.6%, and the overall prevalence of CKD was 2.6%. Multivariate analysis identified diabetes mellitus as the strongest risk factor (OR=4.148) for proteinuria. Other significant predictors for proteinuria included CKD (OR=3.076), hypertension (OR=2.146), advancing age (OR=1.010 per year), and male gender, which had approximately 1.5 times higher odds than female gender (female OR=0.667). A non-linear, U-shaped association was observed for BMI, with both obesity (BMI≥30 kg/m2, OR=1.707) and underweight status (BMI<18.5 kg/m2, OR=1.485) associated with significantly higher odds of proteinuria. The presence of proteinuria was the most powerful predictor (OR=2.940) of CKD. Other significant predictors were advancing age (OR=1.062 per year) and hypertension (OR=1.283). Male gender was associated with 49% lower odds of having CKD compared to females (OR=0.510). 

This study reveals a significant prevalence of dipstick-positive proteinuria and reduced renal function within the asymptomatic, productive population undergoing routine MCU. Proteinuria emerged as the single most powerful independent predictor of reduced renal function, while diabetes mellitus was the most powerful predictor for proteinuria. As the first investigation within a large, productive Indonesian population, these findings emphasize the importance of routine screening for early detection and intervention of CKD.

Kewords