Dipstick proteinuria level is significantly associated with pre-morbid and in-hospital functional status among hospitalized older adults: a preliminary study.
Although chronic kidney disease (CKD) is associated with functional decline, whether proteinuria alone is associated with functional statuses over the course of acute illnesses independent of CKD is unclear. During 2014, we prospectively enrolled non-dialysis patients aged ≥65 years, and all participants underwent spot dipstick urinalysis on admission, divided into 3 groups according to the results (none, trace to 1 + , and 2 + or higher); functional status was evaluated using the pre-morbid and in-hospital Barthel index (BI) scores. Of 136 community-dwelling elderly patients enrolled (age 80.7 ± 8.2 years, with 19% having CKD), 17%, 57%, and 26% had no, trace to 1 + , or 2 + or higher proteinuria. Overall pre-morbid, on-admission, and on-discharge BI scores were 50.4 ± 41.9, 38.6 ± 31.8, and 38.7 ± 35.3, respectively with significant negative correlations with proteinuric severity on admission. Finally, multivariate linear stepwise regression analysis with backward variable selection found that dipstick proteinuric severity was significantly associated with pre-morbid, on-admission, and on-dischrage BI scores (p = 0.048, <0.01, and <0.01, respectively), independent of diabetes and CKD. This relationship between dipstick proteinuric levels and functional status of hospitalized elderly suggests an under-recognized association. Prospective evaluation of long-term outcome is needed.
National Taiwan University College of Medicine, NO.1, Jen-Ai Road Section 1, Taipei 10051, Taiwan.|National Taiwan University Hospital, NO.7, Chung-Shan South Road, Zhong-Zheng district, Taipei 10002, Taiwan.|National Taiwan University Hospital Jin-Shan branch, NO.7, Yulu Road, Jin-Shan district, New Taipei City 208, Taiwan.|National Taiwan University Hospital Hsin-Chu branch, NO.25, Lane 442, Jingguo Road Section 1, Hsin-Chu City 300, Taiwan.
Chia-Ter
CT
Chao
National Taiwan University Hospital Hsin-Chu branch, NO.25, Lane 442, Jingguo Road Section 1, Hsin-Chu City 300, Taiwan.|Department of Traumatology; National Taiwan University Hospital, Taipei, Taiwan.
Hung-Bin
HB
Tsai
National Taiwan University Hospital, NO.7, Chung-Shan South Road, Zhong-Zheng district, Taipei 10002, Taiwan.|National Taiwan University Hospital Hsin-Chu branch, NO.25, Lane 442, Jingguo Road Section 1, Hsin-Chu City 300, Taiwan.|Department of Integrative Diagnostics and Therapeutics, National Taiwan University Hospital, Taipei, Taiwan.
Chih-Kang
CK
Chiang
National Taiwan University Hospital Jin-Shan branch, NO.7, Yulu Road, Jin-Shan district, New Taipei City 208, Taiwan.|National Taiwan University Hospital Hsin-Chu branch, NO.25, Lane 442, Jingguo Road Section 1, Hsin-Chu City 300, Taiwan.
Jenq-Wen
JW
Huang
National Taiwan University Hospital Jin-Shan branch, NO.7, Yulu Road, Jin-Shan district, New Taipei City 208, Taiwan.|National Taiwan University Hospital Hsin-Chu branch, NO.25, Lane 442, Jingguo Road Section 1, Hsin-Chu City 300, Taiwan.|Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu branch, Hsin-Chu County, Taiwan.
Kuan-Yu
KY
Hung
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002846:Chromatography, Affinity; D006760:Hospitalization; D006802:Human Activities; D006801:Humans; D011446:Prospective Studies; D011507:Proteinuria / Q000175:diagnosis* / Q000473:pathology*; D016482:Urinalysis