What Predicts Progression and Regression of Urinary Albumin Excretion in the Nondiabetic Population?

Brantsma, Auke H.; Atthobari, Jarir; Bakker, Stephan J. L.; Zeeuw, Dick de; Jong, Paul E. de; Gansevoort, Ronald

doi:10.1681/asn.2006070738

Cited by 35 publications

(36 citation statements)

References 41 publications

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“…9,10,35 Most of these studies did not adjust for other cardiovascular risk factors, but in two population-based studies in persons without diabetes, increased FG in men and HbAR 1c R in both genders were found to be independent predictors of increased urinary albumin excretion. 22,36 However, neither of these studies excluded persons with diabetes at follow-up.…”

Section: Discussionmentioning

confidence: 99%

Prediabetes and Risk of Glomerular Hyperfiltration and Albuminuria in the General Nondiabetic Population: A Prospective Cohort Study

Melsom

Schei

Stefansson

et al. 2016

American Journal of Kidney Diseases

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Section: Discussionmentioning

confidence: 99%

Prediabetes and Risk of Glomerular Hyperfiltration and Albuminuria in the General Nondiabetic Population: A Prospective Cohort Study

Melsom

Schei

Stefansson

et al. 2016

American Journal of Kidney Diseases

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“…14 It has been shown in populations with diabetes and hypertension that these changes, whether spontaneous or medication induced, are associated with a parallel change in risk for CV disease. 6,7,[15][16][17] In analogy, when we looked at our communitybased study population, changes in UAE were associated with parallel changes in CV risk.…”

Section: Discussionmentioning

confidence: 99%

“…As mentioned, such changes were found to be associated with a significant parallel change in CV risk in our study. Because it is estimated that in the general population after approximately 4 yr of follow-up the incidence of progression is approximately 10%, 14 this suggested that by repeating the UAE measurement, a substantial number of individuals with an increased CV risk can be detected.…”

Section: Discussionmentioning

confidence: 99%

Extended Prognostic Value of Urinary Albumin Excretion for Cardiovascular Events

Brantsma

Bakker

Zeeuw

et al. 2008

Journal of the American Society of Nephrology

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Because urinary albumin excretion (UAE) is a marker of cardiovascular (CV) risk, some have proposed screening the general population; however, it is unknown how the predictive power of a single screening value changes over time. In this study, data of 8496 individuals in a community-based, prospective cohort were used to evaluate this question. For each doubling of baseline UAE, the hazard ratio (HR) for a CV event was 1.36 (95% confidence interval [CI] 1.31 to 1.42). Baseline UAE similarly predicted events occurring Ͼ5 yr after baseline, suggesting that it remains a good predictor during at least the first 5 yr after measurement. Approximately 4 yr after baseline, UAE was measured again in 6800 individuals. Once again, high UAE (Ͼ75th percentile) predicted subsequent CV events, whether defined using the baseline UAE or follow-up UAE (HR 3.39 [95% CI 2.58 to 4.45] and HR 2.50 [95% CI] 1.90 to 3.29, respectively; P ϭ 0.3 for difference). Finally, compared with individuals with consistently low UAE, individuals who progressed from low to high UAE during follow-up had a significantly higher risk for CV events (HR 3.68; 95% CI 2.45 to 5.53). In conclusion, UAE remains a good predictor of CV events during the first 5 yr after measurement, but repeating the measurement several years later also detects progression of UAE, which is also associated with increased CV risk. Future studies are required to determine the optimal interval of repeat testing and its cost-effectiveness. Elevated urinary albumin excretion (UAE) is a powerful independent predictor of cardiovascular (CV) morbidity and mortality in the general population. 1-3 As we showed previously, microalbuminuria (urinary albumin concentration Ͼ10 mg/L) has a relatively high prevalence in the general white population, being approximately 7.2%. Although it is frequently stated that such an elevated UAE is mainly the consequence of diabetes or hypertension, approximately 80% of these individuals reported not to have diabetes or hypertension, and in only approximately 30% of these latter individuals could previously undetected diabetes or hypertension be shown. 4,5 Importantly, it has been shown that treatment associated with a decrease in UAE results in a reduction of the associated CV risk. 6,7 On the basis of these observations, implementation of screening programs in the general population to detect high UAE has been proposed. 8 As shown by the Prevention of Renal and Vascular Endstage Disease (PREVEND) study, mass screening of the general population for high UAE can be done relatively easily by the use of prescreening. 9 In this setting, individuals are initially asked to mail a portion of a first morning void urine sample to a central laboratory for measurement of albumin concentration or, alternatively, the albumin-tocreatinine ratio. Individuals who are found to have

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“…ÕÇÍ ó äèòÿ÷îìó â³ö³ ñïðè÷èíÿþòü àíîìàë³¿ ðîçâèòêó (âðîäaeåí³ àíîìàë³¿ íèðîê ³ ñå÷î-âèâ³äíèõ øëÿõ³â), ôîêàëüíî-ñåãìåíòàðíèé ãëîìåðóëîñêëåðîç (ÔÑÃÑ), ãåìîë³òèêî-óðåì³÷íèé ñèíäðîì (ÃÓÑ), ³ìóííî-êîìïëåêñí³ çàõâîðþâàí-íÿ ³ ñïàäêîâ³ íåôðîïàò³¿, òàê³, ÿê õâîðîáà Àëüïîðòà [2,7]. Çàãàëüíèì ïàòîìîðôîëîã³÷íèì ðåçóëüòàòîì, ùî ñòîñóºòüñÿ ïîøêîäaeåííÿ íèðîê ïðè ÕÇÍ, º ãëîìåðóëîñêëåðîç, ñêëåðîç ñóäèí, òóáóëî-³íòåðñòèö³éíèé ô³áðîç.…”

Section: ïîðóøåííÿ â ñèñòåì³ êîíòðîëþ àïîïòîçó ïðè õðîí³÷íîìó ãëîìåðóunclassified

“…Íà íàñòóïíèõ äîñë³äaeóâàíèõ ñòàä³ÿõ òàêîae ñïîñòåð³ãà-ëîñÿ ³íã³áóâàííÿ Na + , K + -ÀÒÔàçè çà âïëèâó äaeåðåëà ì³êðîõâèëüîâîãî âèïðîì³íþâàííÿ â ðåaeèì³ î÷³êóâàííÿ. Çì³íè, éìîâ³ðíî, ïîâ'ÿçàí³ ç òèì, ùî íà öèõ åòàïàõ ðîçâèòêó â³äáóâàºòüñÿ äåñèíõðîí³çàö³ÿ ïîä³ëó çàðîäêîâèõ êë³òèí, ùî ìîaeå ïðèçâåñòè äî àâòîíîì³çàö³¿ ìåòàáîë³÷íèõ ïðîöåñ³â [2].…”

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Comparative analysis of microwave radiation influence on loach embryos Na+, K+-ATPase activity

Yaremchuk¹,

Dyka²,

Mandzynets³

et al. 2015

Eksp. klìn. fìzìol. bìohìm.

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What Predicts Progression and Regression of Urinary Albumin Excretion in the Nondiabetic Population?

Cited by 35 publications

References 41 publications

Prediabetes and Risk of Glomerular Hyperfiltration and Albuminuria in the General Nondiabetic Population: A Prospective Cohort Study

Prediabetes and Risk of Glomerular Hyperfiltration and Albuminuria in the General Nondiabetic Population: A Prospective Cohort Study

Extended Prognostic Value of Urinary Albumin Excretion for Cardiovascular Events

Comparative analysis of microwave radiation influence on loach embryos Na+, K+-ATPase activity

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