Changes in Proteinuria on the Risk of All-Cause Mortality in People with Diabetes or Prediabetes: A Prospective Cohort Study

J Diabetes Res. 2017:2017:8368513. doi: 10.1155/2017/8368513. Epub 2017 Sep 27.

Abstract

Background: Proteinuria has been related to all-cause mortality, showing regression or progression. However, few studies have focused on the relationship between proteinuria changes and all-cause mortality. The main purpose of this paper is to examine the associations between proteinuria changes and all-cause mortality in people with diabetes or prediabetes.

Methods: Dipstick proteinuria at baseline and a 2-year follow-up were determined in the participants attending the Kailuan prospective cohort study. Participants were then divided into three categories: elevated proteinuria, stable proteinuria, and reduced proteinuria. Four Cox proportional hazard models were built to access the relations of proteinuria changes to all-cause mortality, adjusting for other confounding covariates.

Results: A total of 17,878 participants were finally included in this study. There were 1193 deaths after a median follow-up of 6.69 years. After adjusting for major covariates and proteinuria at baseline, mortality risk was significantly associated with elevated proteinuria (hazard ratio (HR): 1.54, 95% confidence interval (CI): 1.33-1.79) and reduced proteinuria (HR: 0.70, 95% CI: 0.55-0.89), compared to those with stable proteinuria.

Conclusion: Proteinuria changes were independently associated with mortality risk in either diabetic or prediabetic population.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • China / epidemiology
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / mortality*
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prediabetic State / mortality*
  • Prospective Studies
  • Proteinuria / mortality*
  • Risk
  • Survival Rate
  • Young Adult