Role of anemia and proteinuria in the development of subsequent renal function deterioration in a general population with preserved glomerular filtration rate: a community-based cohort study

  • Hiroyuki Kiriyama
  • Hidehiro KanekoEmail author
  • Hidetaka Itoh
  • Yuriko Yoshida
  • Koki Nakanishi
  • Yoshiko Mizuno
  • Masao Daimon
  • Hiroyuki Morita
  • Yutaka Yatomi
  • Issei Komuro
Original Article



Risk factors for renal function deterioration in the general population are not fully understood. We aimed to clarify the determinants of estimated glomerular filtration rate (eGFR) decline using a community-based cohort.

Methods and results

Among 3217 subjects who underwent repeated health check-ups, we excluded 478 subjects with eGFR ≤ 60 mL/min/1.73 m2 and examined 2739 subjects. EGFR decline rate was calculated from the difference in eGFR between the first and last visits. EGFR decline, which was defined as a drop in GFR accompanied by a 25% or greater drop in eGFR from baseline and/or a sustained decline of more than 5 mL/min/1.73 m2/year, was observed in 209 subjects (7.6%). Anemia according to the WHO definition (16.7% vs. 11.7%, p = 0.03), and proteinuria (3.3% vs. 0.8%, p < 0.001) at baseline were more commonly observed in subjects with eGFR decline. Multivariable logistic regression analysis showed that anemia and proteinuria were independently associated with eGFR decline.


Anemia and proteinuria were closely related to eGFR decline, which suggests that we should consider these parameters as risk factors of the development of renal function deterioration even in the general population.


eGFR decline Anemia Proteinuria 



Many thanks to all staffs of the Center for Preventive Medicine at The University of Tokyo Hospital.

Compliance with ethical standards

Conflict of interest

We have no conflict of interest for this study.

Ethical statement

This study was approved by the Medical Ethics Committee of The University of Tokyo and was performed in accordance with the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study by the opt-out procedure.

Supplementary material

40620_2019_605_MOESM1_ESM.docx (28 kb)
Supplementary material 1 (DOCX 28 kb)
40620_2019_605_MOESM2_ESM.tif (52 kb)
Supplementary material 2 (TIFF 52 kb)


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Copyright information

© Italian Society of Nephrology 2019

Authors and Affiliations

  • Hiroyuki Kiriyama
    • 1
  • Hidehiro Kaneko
    • 1
    • 2
    Email author
  • Hidetaka Itoh
    • 1
  • Yuriko Yoshida
    • 1
  • Koki Nakanishi
    • 1
  • Yoshiko Mizuno
    • 1
  • Masao Daimon
    • 1
    • 3
  • Hiroyuki Morita
    • 1
  • Yutaka Yatomi
    • 3
  • Issei Komuro
    • 1
  1. 1.The Department of Cardiovascular MedicineThe University of TokyoTokyoJapan
  2. 2.The Department of Advanced CardiologyThe University of TokyoTokyoJapan
  3. 3.The Department of Clinical LaboratoryThe University of Tokyo HospitalTokyoJapan

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