Care gaps following newly detected dipstick proteinuria in treated hypertension: a Japanese nationwide database study
Authors' conclusion
Follow-up quantitative testing and RASi initiation after newly detected dipstick proteinuria were infrequent, even among patients with higher dipstick grades, and RASi initiation showed no clear improvement over time. These findings highlight opportunities to improve guideline-concordant urinary protein assessment and antihypertensive therapy.
Study context
- Population
- Treated hypertensive patients with newly detected dipstick proteinuria (≥1+, with prior results <1+) between January 2005 and March 2025overall population, 14,599 baseline renin-angiotensin system inhibitors (RASi) non-users · baseline RASi non-users 14,599
- Participants
- 47,210 patients
- Exposure
- 2+ proteinuria vs 3+ proteinuria
- Outcome
- Quantitative urine albumin/protein testing, cumulative incidence
- Follow-up
- 365 days
Methodological detailsJMDC claims database
- JMDC claims database
Main finding
As reported in the abstract
Overall population (n = 47 210)
7.5% [95% confidence interval (CI): 7.2-7.7]
Observational data: associations, not effects.
Further findings
| Outcome | 2+ proteinuria | 3+ proteinuria |
|---|---|---|
| Quantitative testing and RASi initiation by dipstick grade | ||
| Quantitative testing | 12.9 | 16.1% |
| RASi initiation | 17.5 | 21.7% |
RASi initiation, cumulative incidence · 365 days
- Baseline RASi non-users (n = 14 599)
- 13.2% (95% CI: 12.6-13.8)
- Kaplan-Meier method
Quantitative testing and RASi initiation by dipstick grade
- Both outcomes became more frequent with increasing dipstick grade but remained infrequent in the higher-grade groups
Temporal trend in RASi initiation
- aHR per year
- 1.01; 95% CI: 0.99-1.03
- RASi initiation rates showed no improvement
Original publication
Care gaps following newly detected dipstick proteinuria in treated hypertension: a Japanese nationwide database study. Eur Heart J Qual Care Clin Outcomes. Published 19 September 2026. doi:10.
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