Outcomes associated with microalbuminuria: Effect modification by chronic kidney disease

Csaba P. Kovesdy, Evan H. Lott, Jun Ling Lu, Sandra M. Malakauskas, Jennie Z. Ma, M. Molnár, Kamyar Kalantar-Zadeh

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objectives: This study sought to compare the association of microalbuminuria with outcomes in patients with different comorbidities. Background: The risk of adverse outcomes associated with lower levels proteinuria has been found to be linearly decreasing with even low-normal levels of microalbuminuria. It is unclear whether comorbid conditions change these associations. Methods: We examined the association of urine microalbumin- creatinine ratio (UACR) with mortality and the slopes of estimated glomerular filtration rate (eGFR) in a nationally representative cohort of 298,875 U.S. veterans. Associations of UACR with all-cause mortality overall and in subgroups of patients with and without diabetes mellitus, hypertension, cardiovascular disease, congestive heart failure, and advanced chronic kidney disease (CKD) were examined in Cox models, and with the slopes of eGFR in linear and logistic regression models. Results: Very low levels of UACR were linearly associated with decreased mortality and less progression of CKD overall: adjusted mortality hazard ratio and estimated glomerular filtration rate slope (95% confidence interval [CI]) associated with UACR ≥200 μg/mg, compared to

Original languageEnglish
Pages (from-to)1626-1633
Number of pages8
JournalJournal of the American College of Cardiology
Volume61
Issue number15
DOIs
Publication statusPublished - Apr 16 2013

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Chronic Renal Insufficiency
Creatinine
Glomerular Filtration Rate
Urine
Mortality
Logistic Models
Veterans
Proteinuria
Proportional Hazards Models
Comorbidity
Linear Models
Diabetes Mellitus
Cardiovascular Diseases
Heart Failure
Confidence Intervals
Hypertension

Keywords

  • chronic kidney disease
  • microalbuminuria
  • mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Outcomes associated with microalbuminuria : Effect modification by chronic kidney disease. / Kovesdy, Csaba P.; Lott, Evan H.; Lu, Jun Ling; Malakauskas, Sandra M.; Ma, Jennie Z.; Molnár, M.; Kalantar-Zadeh, Kamyar.

In: Journal of the American College of Cardiology, Vol. 61, No. 15, 16.04.2013, p. 1626-1633.

Research output: Contribution to journalArticle

Kovesdy, Csaba P. ; Lott, Evan H. ; Lu, Jun Ling ; Malakauskas, Sandra M. ; Ma, Jennie Z. ; Molnár, M. ; Kalantar-Zadeh, Kamyar. / Outcomes associated with microalbuminuria : Effect modification by chronic kidney disease. In: Journal of the American College of Cardiology. 2013 ; Vol. 61, No. 15. pp. 1626-1633.
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