A1897 Effectiveness of the dipstick urine test for identifying chronic kidney disease in Japanese male workers over 40 years old

Tuesday, March 20, 2012
Ground Floor (Cancun Center)
Masatoshi Kawashima, Department of Occupational Health, Graduate School Of Medical Sciences, Kitasato University, Sagamihara, Japan
Koji Wada, Department of Preventive Medicine and Public Health, Kitasato University School of Medicine, Sagamihara, Japan
Haruka Odoi, Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
Kenichiro Bando, Health care center, Central Japan Railway Company, Nagoya, Japan
Kazuhiko Enta, Shizuoka health care center, Central Japan Railway Company, Shizuoka, Japan
Shunsuke Sashihara, Health care center, Central Japan Railway Company, Nagoya, Japan
Yoshiharu Aizawa, Department of Preventive Medicine, Kitasato University School of Medicine, Sagamihara, Japan
Introduction
Chronic kidney disease (CKD) precedes end-stage renal disease. In 2009, Kidney Disease: Improving Global Outcomes (KDIGO) proposed new guidelines regarding the composite ranking for relative risks by glomerular filtration rate (GFR) and albuminuria. In Japan, all employees are required to check proteinuria by the dipstick urine test. In our company, serum creatinine of all workers aged ≥40 years is measured additionally, so GFR can be estimted. However, GFR is not routinely measured, and therefore, it may not be sufficient to identify CKD. We evaluated the effectiveness of the dipstick urine test for identifying CKD.

Methods
Our study was conducted in all male workers aged ≥40 years who were employed at a railway company in Japan between 2007 and 2010. The urine dipstick test was performed to evaluate albuminuria excretion on a scale of (-), (±), (+), (2+), (3+) and (4+). The GFR was estimated using the equation for Japanese. We calculated the number of participants who fit the definition of CKD in the new guidelines by albuminuria only and combination of albuminuria and GFR.

Results
A total of 7763 workers were included. A total of 381 participants (4.9%) had an albuminuria excretion of (+) or higher and fit the definition of CKD by albuminuria only. A total of 1179 participants (15.2%) had albuminuria and/or GFR<60 and fit the definition of CKD by a combination of albuminuria and GFR. Therefore, a total of 798 participants (10.3%) did not fit the definition of CKD by albuminuria only.

Discussion
A total of 67.7% of participants who fit the definition of CKD were overlooked using albuminuria excretion only. Therefore, it is not sufficient to identify CKD by dipstick urine test only. Both the urine dipstick test and GFR measurement are required to identify CKD and not to progress to end-stage renal disease.

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