title: Elevated white blood cell count worsens proteinuria but not estimated glomerular filtration rate: the Kansai Healthcare Study.
abstract: OBJECTIVE
  No prospective studies have estimated the association between white blood cell (WBC) count and the risk of proteinuria. We prospectively examined the relationships of WBC count, as a marker of inflammation, with two outcomes: proteinuria and low estimated glomerular filtration rate (eGFR).
  
  
  METHODS
  We enrolled 10,008 Japanese men aged 40-55 years who had neither proteinuria nor low eGFR and were not taking antihypertensive medications at entry. Proteinuria was defined as 1+ or higher on urine dipstick. Low eGFR was defined if eGFR was <60 ml/min/1.73 m(2).
  
  
  RESULTS
  During the 49,644 person-years of follow-up, 1,557 cases of proteinuria were confirmed. After adjusting for age, body mass index, fasting plasma glucose, systolic blood pressure, diastolic blood pressure, antidiabetic medications, alcohol consumption, smoking, regular leisure-time physical activity and eGFR, the highest quintile (≥7.51 × 10(3)/μl) of WBC count was independently associated with an increased risk of incidence of proteinuria [HR: 1.45 (95% CI: 1.23-1.73)] compared with the lowest quintile (≤4.80 × 10(3)/μl). On the other hand, during 52,833 person-years, we confirmed 439 cases of low eGFR. In multivariate models, there was no association between WBC count and low eGFR.
  
  
  CONCLUSIONS
  Elevated WBC count was independently associated with an increased risk of proteinuria, but not low eGFR.
authors.affiliation: Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan. ksato@med.osaka-cu.ac.jp
authors.forename: Kyoko Kogawa
authors.initials: KK
authors.lastname: Sato
authors.forename: Tomoshige
authors.initials: T
authors.lastname: Hayashi
authors.forename: Nobuko
authors.initials: N
authors.lastname: Harita
authors.forename: Hideo
authors.initials: H
authors.lastname: Koh
authors.forename: Isseki
authors.initials: I
authors.lastname: Maeda
authors.forename: Ginji
authors.initials: G
authors.lastname: Endo
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kambe
authors.forename: Kanji
authors.initials: K
authors.lastname: Fukuda
mesh_terms: D000328:Adult; D001772:Blood Cell Count; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D005919:Glomerular Filtration Rate; D006801:Humans; D007564:Japan; D007962:Leukocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011507:Proteinuria / Q000378:metabolism / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose