Urinary type IV collagen excretion is involved in the decline in estimated glomerular filtration rate in the Japanese general population without diabetes: A 5-year observational study

Urinary type IV collagen (U-Co14) and albumin excretion is evaluated to monitor the development of diabetic kidney disease. However, U-Co14 excretion in the general population without diabetes has not yet been fully elucidated. In this study, 1067 participants without diabetes and with urinary albumin-creatinine ratio <300 mg/gCr (normo- or microalbuminuria) who underwent an annual health examination in 2004 were enrolled and observed for 5 years. They were divided according to the amount of U-Co14 or urinary albumin excreted. The decline in estimated glomerular filtration rate (eGFR) was calculated. In participants with eGFR >= 80 mUmin, abnormal U-Co14 excretion was indicated as a significant independent risk factor for 10% eGFR change per year, which is one of the prognostic factors for the development of end stage kidney disease. Moreover, in contrast to urinary albumin excretion, U-Co14 excretion was not related to age or kidney function, suggesting that some individuals with abnormal U-Co14 excretion can have an independent hidden risk for the development of kidney dysfunction. In conclusion, it is important to measure U-Co14 excretion in the general population without diabetes to determine changes in renal features in every individual and help detect future complications such as diabetic kidney disease. If U-Co14 excretion is abnormal, kidney manifestation should be carefully followed up, even if the kidney function and urinalysis findings are normal.