Is proteinuria a plausible target of therapy?

Chua, Dave; Bakris, George L.

doi:10.1007/s11906-004-0066-9

Cited by 23 publications

(6 citation statements)

References 53 publications

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“…Patients with higher baseline proteinuria experienced a relatively faster rate of GFR decline and benefited more from the lower BP goal (1). Numerous analyses have since confirmed this observation (21)(22)(23). Thus, the selection of BP-lowering medications for patients with renal disease should be based on the efficacy of these agents in reducing proteinuria (1).…”

Section: Higher Proteinuria Linked To Faster Decline In Gfrmentioning

confidence: 89%

Slowing Nephropathy Progression

Bakris¹

2008

Clinical Journal of the American Society of Nephrology

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117

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Section: Higher Proteinuria Linked To Faster Decline In Gfrmentioning

confidence: 89%

Slowing Nephropathy Progression

Bakris¹

2008

Clinical Journal of the American Society of Nephrology

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117

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“…For example, proteinuria and microalbuminuria are adverse consequences of systemic hypertension in animals with coexistent CKD. With respect to the benefits of decreasing BP in animals with CKD, decreasing the magnitude of proteinuria is perhaps the most effective treatment goal, 161 particularly in cats.…”

Section: The Hypertensive Patient: Follow-upmentioning

confidence: 99%

Guidelines for the Identification, Evaluation, and Management of Systemic Hypertension in Dogs and Cats

Brown

Atkins

Bagley

et al. 2007

Veterinary Internal Medicne

558

512

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Consensus Statements of the American College of Veterinary Internal Medicine (ACVIM) provide veterinarians with guidelines regarding the pathophysiology, diagnosis, or treatment of animal diseases. The foundation of the Consensus Statement is evidence‐based medicine, but if such evidence is conflicting or lacking, the panel provides interpretive recommendations on the basis of their collective expertise. The Consensus Statement is intended to be a guide for veterinarians, but it is not a statement of standard of care or a substitute for clinical judgment. Topics of statements and panel members to draft the statements are selected by the Board of Regents with input from the general membership. A draft prepared and input from Diplomates is solicited at the ACVIM Forum and via the ACVIM Web site and incorporated in a final version. This Consensus Statement was approved by the Board of Regents of the ACVIM before publication.

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“…Toyama et al ( 26 ), in a systematic review and meta-analysis of 31 studies, have reported an increased risk of cardiovascular mortality with microalbuminuria [risk ratio (RR), 1.76; 95% CI, 1.38–2.25] and macroalbuminuria (RR, 2.96; 95% CI, 2.44–3.60) as compared to normoalbuminuria in diabetics. Guidelines for the management of hypertension recommend screening as well as targeted management of albuminuria in addition to controlling blood pressure for better clinical outcomes ( 27 ). Despite evidence suggesting the deleterious effects of albuminuria independent of kidney function in patients with other cardiovascular diseases ( 28 , 29 ), there has been limited research on the prognostic significance of this biomarker specifically in heart failure patients.…”

Section: Discussionmentioning

confidence: 99%

Albuminuria and Dipstick Proteinuria for Predicting Mortality in Heart Failure: A Systematic Review and Meta-Analysis

Liang

Liu

Wang

et al. 2021

Front. Cardiovasc. Med.

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Background: Research suggest that albuminuria is not only an independent risk factor for the development of heart failure but may also act as a biomarker for predicting adverse outcomes. To date, no study has synthesized evidence on its role as a prognostic indicator. Thus, the current study aimed to quantitatively assess the prognostic utility of albuminuria as well as dipstick proteinuria in predicting mortality in heart failure patients.Methods: PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases were searched up to October 10, 2020. All studies reporting multivariable-adjusted hazard ratios (HR) for albuminuria or dipstick proteinuria for mortality and/or hospitalization in heart failure patients were included.Results: Eleven studies were included. Seven assessed albuminuria and five assessed dipstick proteinuria. Our analysis revealed a statistically significant increased risk of all-cause mortality with microalbuminuria (HR: 1.54; 95% CI, 1.23–1.93; I2 = 79%; p = 0.0002) and macroalbuminuria (HR: 1.76; 95% CI, 1.21–2.56; I2 = 88%; p = 0.003) in heart failure patients. The risk of all-cause mortality and hospitalization was also significantly increased with macroalbuminuria. Microalbuminuria was associated with significantly increased cardiovascular mortality and combined cardiovascular mortality and hospitalization. Positive dipstick test for proteinuria was significantly associated with mortality in heart failure (HR: 1.54; 95% CI, 1.28–1.84; I2 = 67%; p < 0.00001).Conclusion: Both microalbuminuria and macroalbuminuria are predictors of mortality in patients with heart failure. Dipstick proteinuria may be used as a rapid screening test to predict mortality in these patients.

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Is proteinuria a plausible target of therapy?

Cited by 23 publications

References 53 publications

Slowing Nephropathy Progression

Slowing Nephropathy Progression

Guidelines for the Identification, Evaluation, and Management of Systemic Hypertension in Dogs and Cats

Albuminuria and Dipstick Proteinuria for Predicting Mortality in Heart Failure: A Systematic Review and Meta-Analysis

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