Microalbuminuria and cardiovascular (CV) risk

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