BACKGROUND: Albuminuria is a known risk factor for cardiovascular events and premature deaths. However, the association between urinary albumin excretion and mortality is unknown in the Japanese population. To clarify this, we conducted a community-based longitudinal study. METHODS: This study included 3,445 registered Japanese subjects (mean age 62.6 years), with a 7-year follow-up. Albuminuria was defined as a urine albumin-creatinine ratio (ACR) ≥30 mg/g in the morning spot urine. RESULTS: Subjects with albuminuria (n = 514, 14.9 %) were older and showed a higher prevalence of hypertension, obesity, and diabetes and lower values of estimated glomerular filtration rate (eGFR) than those without albuminuria (n = 2931, 85.1 %). During the follow-up, 138 subjects died. A Kaplan-Meier analysis showed that all-cause mortality significantly increased along with the increase in urine albumin excretion (log-rank test, P < 0.001). The subjects with albuminuria showed a significantly higher mortality rate than those without albuminuria (7.4 vs. 3.4 %; log-rank test, P < 0.001). A Cox proportional hazard model analysis after adjusting for possible confounders showed that albuminuria was an independent risk factor for all-cause and cardiovascular mortality (hazard ratio [HR] 1.69, 95 % confidence interval [CI] 1.12-2.56 and HR 2.27, 95 % CI 1.10-4.70, respectively) but not for noncardiovascular mortality. These associations were preserved after excluding subjects with high ACR (≥300 mg/g). CONCLUSIONS: Albuminuria was a risk factor for all-cause and cardiovascular mortality in the Japanese population. To detect subjects with a high risk for premature death, measuring urinary albumin excretion might be useful.
BACKGROUND:Albuminuria is a known risk factor for cardiovascular events and premature deaths. However, the association between urinary albumin excretion and mortality is unknown in the Japanese population. To clarify this, we conducted a community-based longitudinal study. METHODS: This study included 3,445 registered Japanese subjects (mean age 62.6 years), with a 7-year follow-up. Albuminuria was defined as a urine albumin-creatinine ratio (ACR) ≥30 mg/g in the morning spot urine. RESULTS: Subjects with albuminuria (n = 514, 14.9 %) were older and showed a higher prevalence of hypertension, obesity, and diabetes and lower values of estimated glomerular filtration rate (eGFR) than those without albuminuria (n = 2931, 85.1 %). During the follow-up, 138 subjects died. A Kaplan-Meier analysis showed that all-cause mortality significantly increased along with the increase in urine albumin excretion (log-rank test, P < 0.001). The subjects with albuminuria showed a significantly higher mortality rate than those without albuminuria (7.4 vs. 3.4 %; log-rank test, P < 0.001). A Cox proportional hazard model analysis after adjusting for possible confounders showed that albuminuria was an independent risk factor for all-cause and cardiovascular mortality (hazard ratio [HR] 1.69, 95 % confidence interval [CI] 1.12-2.56 and HR 2.27, 95 % CI 1.10-4.70, respectively) but not for noncardiovascular mortality. These associations were preserved after excluding subjects with high ACR (≥300 mg/g). CONCLUSIONS:Albuminuria was a risk factor for all-cause and cardiovascular mortality in the Japanese population. To detect subjects with a high risk for premature death, measuring urinary albumin excretion might be useful.
Authors: Hans L Hillege; Vaclav Fidler; Gilles F H Diercks; Wiek H van Gilst; Dick de Zeeuw; Dirk J van Veldhuisen; Rijk O B Gans; Wilbert M T Janssen; Diederick E Grobbee; Paul E de Jong Journal: Circulation Date: 2002-10-01 Impact factor: 29.690
Authors: T Konta; Z Hao; H Abiko; M Ishikawa; T Takahashi; A Ikeda; K Ichikawa; S Takasaki; I Kubota Journal: Kidney Int Date: 2006-08 Impact factor: 10.612
Authors: Kunihiro Matsushita; Marije van der Velde; Brad C Astor; Mark Woodward; Andrew S Levey; Paul E de Jong; Josef Coresh; Ron T Gansevoort Journal: Lancet Date: 2010-05-17 Impact factor: 79.321
Authors: H C Gerstein; J F Mann; Q Yi; B Zinman; S F Dinneen; B Hoogwerf; J P Hallé; J Young; A Rashkow; C Joyce; S Nawaz; S Yusuf Journal: JAMA Date: 2001-07-25 Impact factor: 56.272
Authors: Andrew S Levey; Paul E de Jong; Josef Coresh; Meguid El Nahas; Brad C Astor; Kunihiro Matsushita; Ron T Gansevoort; Bertram L Kasiske; Kai-Uwe Eckardt Journal: Kidney Int Date: 2010-12-08 Impact factor: 10.612
Authors: Marije van der Velde; Kunihiro Matsushita; Josef Coresh; Brad C Astor; Mark Woodward; Andrew Levey; Paul de Jong; Ron T Gansevoort; Marije van der Velde; Kunihiro Matsushita; Josef Coresh; Brad C Astor; Mark Woodward; Andrew S Levey; Paul E de Jong; Ron T Gansevoort; Andrew Levey; Meguid El-Nahas; Kai-Uwe Eckardt; Bertram L Kasiske; Toshiharu Ninomiya; John Chalmers; Stephen Macmahon; Marcello Tonelli; Brenda Hemmelgarn; Frank Sacks; Gary Curhan; Allan J Collins; Suying Li; Shu-Cheng Chen; K P Hawaii Cohort; Brian J Lee; Areef Ishani; James Neaton; Ken Svendsen; Johannes F E Mann; Salim Yusuf; Koon K Teo; Peggy Gao; Robert G Nelson; William C Knowler; Henk J Bilo; Hanneke Joosten; Nanno Kleefstra; K H Groenier; Priscilla Auguste; Kasper Veldhuis; Yaping Wang; Laura Camarata; Beverly Thomas; Tom Manley Journal: Kidney Int Date: 2011-02-09 Impact factor: 10.612
Authors: Roland E Schmieder; Rudolph Schutte; Helmut Schumacher; Michael Böhm; Giuseppe Mancia; Michael A Weber; Matthew McQueen; Koon Teo; Salim Yusuf Journal: Diabetologia Date: 2014-07-19 Impact factor: 10.122