Isolated Microalbuminuria Indicates a Poor Prognosis

Isolated microalbuminuria—microalbuminuria in the absence of a history of cardiovascular disease (CVD), hypertension, and diabetes—indicates a poor prognosis, researchers reported.

Ron T. Gansevoort, MD, of the Department of Nephrology at University Medical Center Groningen in Groningen, the Netherlands, and colleagues studied 8,356 subjects who participated in the first four screening rounds of the PREVEND study, a prospective, community-based observational cohort study.

Of these, 300 met the definition of isolated microalbuminuria (microalbuminuria 30-300 mg/24 hours in the absence of a CVD history, hypertension [blood pressure below 140/90 mm Hg, not using BP-lowering drugs], and diabetes [fasting glucose level below 7.0 mmol/L, not using glucose-lowering drugs]).

The cohort had 2,250 person-years of follow-up information available. Subjects with isolated microalbuminuria had incidence rates of cardiovascular events and mortality, hypertension, and diabetes of 15.3, 28.9, and 8.9 per 1,000 person-years of follow-up, respectively.

They had a significant twofold increased risk of cardiovascular events and death, a twofold increased of hypertension, and a nearly fivefold increased risk of diabetes compared with subjects without microalbuminuria, a CVD history, hypertension, and/or diabetes, the researchers reported online ahead of print in Nephrology Dialysis Transplantation. The increased risk remain after adjusting for age and gender.

The authors noted that the increased relative risk associated with isolated microalbuminuria was similar to the relative risk among patients with microalbuminuria who did have a CVD history, hypertension, and/or diabetes.

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