Frequency and sequence of proteinuria positivity and clinical outcomes in patients with diabetes: A nationwide cohort study
Authors' conclusion
The proteinuria burden was dose-dependently associated with clinical outcomes in patients with diabetes. Even a single positive dipstick test requires active management.
Study context
- Population
- Patients with diabetes who participated in a national health screening in 2015–2016, with records of three previous health screenings; followed until 31 December 2022
- Participants
- 1,264,699 patients
- Exposure
- Proteinuria burden 1, 2, 3 and 4 vs proteinuria burden 0
- Outcome
- End-stage kidney disease (ESKD), cardiovascular disease (CVD) and all-cause mortality
- Follow-up
- Until 31 December 2022
Methodological detailsnationwide, Korean National Health Insurance Service database
- Nationwide
- Korean National Health Insurance Service database
Main finding
As reported in the abstract
Each group vs proteinuria burden 0Adjusted hazard ratio (95% CI)
Proteinuria burden 1ESKD
3.539(3.326–3.766)
Proteinuria burden 2ESKD
9.373(8.816–9.965)
Proteinuria burden 3ESKD
14.539(13.652–15.484)
Proteinuria burden 4ESKD
19.704(18.412–21.087)
Proteinuria burden 1CVD
1.247(1.214–1.280)
Proteinuria burden 2CVD
1.530(1.465–1.599)
Proteinuria burden 3CVD
1.815(1.713–1.923)
Proteinuria burden 4CVD
2.032(1.883–2.192)
Proteinuria burden 1All-cause mortality
1.335(1.302–1.369)
Proteinuria burden 2All-cause mortality
1.703(1.635–1.774)
Proteinuria burden 3All-cause mortality
1.959(1.855–2.068)
Proteinuria burden 4All-cause mortality
2.092(1.945–2.250)
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Distribution of proteinuria burden | Proteinuria burden 0 86.3% · Proteinuria burden 1 9.4% · Proteinuria burden 2 2.5% · Proteinuria burden 3 1.2% · Proteinuria burden 4 0.6% |
Sequence of proteinuria positivity
- Within the same proteinuria burdens, late-positive proteinuria was associated with worse outcomes than early-positive proteinuria
Original publication
Frequency and sequence of proteinuria positivity and clinical outcomes in patients with diabetes: A nationwide cohort study. Diabetes Obes Metab. Published 4 April 2025. doi:10.
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