Albuminuria and cardiovascular disease risk ( CVD )

There is evidence from the HOPE study that the presence of albuminuria indicates increased risk for myocardial infarction, stroke, cardiovascular death, congestive heart failure, and all-cause mortality.

Summary results:

Authors of the study point out that many cardiovascular risk factors are associated with microalbuminuria, including smoking, hypertension, dyslipidaemia, hyperhomocystinemia, dietary protein, and markers of acute phase response. There is a need for further research to clearly assess the independent cardiovascular risk that occurs as a result of the presence (and degree) of albuminuria.

Glomerular Filtration and microalbuminuria:

• evidence from a Norwegian cohort study reveals that the combination of a glomerular filtration rate < 45 ml/min/1.73m^2 and microalbuminuria was a strong predictor of cardiovascular death (2)
  • reduced kidney function and microalbuminuria were risk factors for cardiovascular death, independent of each other and traditional risk factors
• a US study revealed that moderately decreased estimated GFR and albuminuria independently predict cardiovascular and all-cause mortality in the general population (3)

Reference:

• (1) Gerstein HG et al, for the HOPE study investigators. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and non-diabetic individuals. JAMA 2001;286:421-6.
• (2) Hallan S et al. Association of kidney function and albuminuria with cardiovascular mortality in older vs younger individuals: The HUNT II Study. Arch Intern Med. 2007 Dec 10;167(22):2490-6.
• (3) Astor BC et al. Glomerular filtration rate, albuminuria, and risk of cardiovascular and all-cause mortality in the US population. Am J Epidemiol. 2008 May 15;167(10):1226-34