Albuminuria Ups Death Risk Despite Normal Renal Function

Albuminuria increases death risk 2-fold among individuals with an estimated glomerular filtration rate of 60 mL/min/1.73 m2 or higher.
Albuminuria increases death risk 2-fold among individuals with an estimated glomerular filtration rate of 60 mL/min/1.73 m2 or higher.

BOSTON—Albuminuria is associated with an increased risk of death even among individuals with normal kidney function, according to study findings presented at the National Kidney Foundation 2016 Spring Clinical Meetings.

Individuals with albuminuria who had an estimated glomerular filtration rate (eGFR) of 60 mL/min/1.73 m2 or higher had a nearly 2-fold increased risk of death compared with those who did not have albuminuria, Jennifer Bragg-Gresham, PhD, a research scientist at the University of Michigan in Ann Arbor, and colleagues reported.

“Our results suggest that increased albuminuria testing, even among those with normal eGFR, could provide the impetus for preventive measures to lower mortality risk,” Dr. Bragg-Gresham said in an NKF press release.

She and her colleagues studied 28,044 adult participants in the National Health and Nutrition Examination Survey (1999–2010). They defined albuminuria as a urine albumin-to-creatinine ratio greater than 30 mg/g and calculated eGFR using the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation. The study excluded individuals with kidney failure.

 

The prevalence of albuminuria increased with decreasing eGFR. The prevalence rates were 8%, 23.3%, 43%, 66.5%, among individuals with an eGFR (in mL/min/1.73 m2) of 60 or higher, 45–59, 30–44, and less than 30, respectively. Individuals in these eGFR categories had a 1.9, 1.6, 2.0 and 2.2 times increased risk of death, respectively.

Previous studies have shown that albuminuria increases the risk for cardiovascular disease and is associated with a more rapid progression of kidney disease and increased risk of kidney failure.

“Based on our estimates, over 15 million people in the United States have albuminuria without a decrease in eGFR,” Dr. Bragg-Gresham said. “If less than 5% of these individuals are aware they have early stage kidney disease, there are potentially more than 14.5 million individuals who could be identified and measures taken to slow the progression of their kidney disease and reduce their risk of all-cause mortality.”

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