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《Shanghai Medical Journal》 2012-09
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Urinalysis and renal function abnormalities in the single test during health examination: the results of 35 089 cases

XUE Ning, YUAN Min, ZHONG Yihong, CHEN Liming, DING Xiaoqiang. Department of Nephrology, Blood purification centre, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
Objective To investigate the prevalence of proteinuria, hematuria, leucocyturia and reduced renal function in general population and to provide some information for early diagosis of renal diseases. Methods People who took health examination in Zhongshan Hospital of Fudan University from January to December 2008 were enrolled in the study. The criteria of reduced renal function were ① Kidney Early Evaluation Program (KEEP) criterion: serum creatinine133 μmol/L for male and 115 μmol/L for female; ② National Health and Nutrition Examination Survey (NHANES) Ⅲ criterion: serum creatinine 124 μmol/L for male and 106 μmol/L for female aged less than 65 years, serum creatinine≥115 μmol/L for male and ≥88.4 μmol/L for female aged over 65 years old. Results A total of 2 804 cases were found with abnormal results of urinalysis. The average age of the patients was (42.2±14.3) years (ranged from 19 to 92 years). The prevalence of urinalysis abnormalities was 8.0% (2 804/35 089), and abnormalities in men were much more than those in women (P0.05). The prevalences of proteinuria, hematuria, proteinuria+hematuria, and leukocyturia were 2.0% (703/35 089), 2.6% (899/35 089), 0.8% (284/35 089), and 2.6% (918/35 089), respectively. There were no significant difference in age and gender in proteinuria, proteinuria+hematuria and leucocyturia patients (all P0.05). There was no significant difference in age for hematuria detection rate (P0.05), but the prevalence of hematuria in males less than 45 years old was significantly higher than that in females (P0.05). The average levels of serum creatinine was (72.9±17.3) μmol/L for all examinees. The prevalence of reduced renal function was 0.2% and 0.3% according to KEEP and NHANSE III criteria, respectively, and the detection rate in males was significantly higher than that in females (P0.01). The examinees were divided into young group (≤45 years old), middle-aged group (46-64 years old) and old group (≥65 years old). According to KEEP criterion, the prevalence of reduced renal function in males was significantly higher than that is females in the old group (P0.01); the prevalence of reduced renal function in the old group was significantly higher than that in the middle-aged group and young group (P0.01). According to NHANES Ⅲ criterion, the prevalence of reduced renal function in males was significantly higher than that in females in the middle-aged group and old group (P0.05, P0.01). The prevalence of reduced renal function was gradually increased as the age increased (P0.01). There was no statistical difference of serum creatinine level in the people with positive and negative urinalysis (73.6±26.6 μmol/L vs. 72.8±15.9 μmol/L, P0.05). Serum creatinine level in proteinuria and proteinuria+hematuria patients were (73.5±15.4) μmol/L and (76.1±68.6) μmol/L, which was significantly higher than that in people with negative urinalysis (all P0.05). According to KEEP and NHANES Ⅲ criteria, the prevalence of reduced renal function in patients with positive urinalysis, especially that in proteinuria+hematuria patients, was significantly higher than those in people with negative urinalysis (P0.05). According to NHANES Ⅲ criterion, the prevalence of reduced renal function in patients with proteinuria was significantly higher than that in people with negative urinalysis (P0.05). According to KEEP and NHANES Ⅲ criteria, the prevalence of proteinuria+hematuria in reduced renal function patients was significantly higher than normal renal function people (P0.05). According to NHANES Ⅲ criterion, the prevalence of proteinuria in reduced renal function patients was significantly higher than normal renal function people (P0.05). There was no statistical difference in hematuria between reduced renal function patients and normal renal function people (P0.05). Conclusion The prevalence of urinalysis abnormalities and reduced renal function in general population is very high. It is important to pay more attention to urinalysis and renal function test in health examination to detect chronic kidney disease in early stage.
【Fund】: 上海市重大课题(08DZ1900602);; 教育部国家“211工程”重点学科建设项目(211XK20)资助项目
【CateGory Index】: R194.3
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