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Microalbuminuria and cardiovascular (CV) risk

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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:

outcomes at median 4.5 years

with microalbuminuria

without microalbuminuriaa

adjusted RR (95% CI)

major cardiovascular events



1.83 (1.64-2.05)

all-cause mortality



2.09 (1.84-2.38)

CHF hospital admission



3.23 (2.54-4.10)

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)


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