Cardiovascular risk-factors predict progression of urinary albumin-excretion in a general, non-diabetic population

Solbu, Marit Dahl; Kronborg, Jens; Eriksen, Bjørn Odvar; Jenssen, Trond; Toft, Ingrid

doi:10.1016/j.atherosclerosis.2008.02.027

Cited by 33 publications

(29 citation statements)

References 29 publications

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“…Albuminuria is considered to be the result of generalized endothelial dysfunction, 31 and is shown to coexist with cardiovascular risk factors such as higher age, obesity, hypertension, early disturbances in glucose metabolism, and diabetes. [32][33][34][35] In the present study, increased NAG ratio was found in the same risk groups, which is in line with the existing literature. 20,22,[36][37][38][39][40][41] The associations with the end points may therefore in part be explained by the more adverse risk profile among individuals with increased NAG ratio.…”

Section: Discussionsupporting

confidence: 81%

N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population

Solbu

Toft

Løchen

et al. 2016

Journal of the American Society of Nephrology

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Albuminuria is a well known risk factor for cardiovascular disease and mortality, but focus on renal tubular dysfunction as a potential risk factor is growing also. The association between the urinary activity of N-acetylb-D-glucosaminidase (NAG) and cardiovascular risk has been assessed mostly in cross-sectional studies. We studied the cross-sectional associations between urinary NAG and cardiovascular risk factors and the longitudinal associations between NAG, cardiovascular disease, and all-cause mortality in a general population. Urinary NAG/creatinine ratio (NAG ratio) and albumin/creatinine ratio (ACR) were measured in 6834 participants of the Tromsø Study in 1994-1995. During the median 17.5 years of follow-up, 958 myocardial infarctions, 726 ischemic strokes, and 2358 deaths were registered. In multivariable analyses adjusted for albuminuria and cardiovascular risk factors, a baseline NAG ratio in the highest quartile was associated with an increased risk of myocardial infarction (hazard ratio [HR], 1.43; 95% confidence interval [95% CI], 1.16 to 1.76), ischemic stroke (HR, 1.41; 95% CI, 1.10 to 1.80), and all-cause mortality (HR, 1.60; 95% CI, 1.39 to 1.84). Combined, ACR and NAG ratio above median associated with a 48%-80% increased risk for the three end points. However, the NAG ratio did not add significantly to the baseline risk-prediction models when assessed by area under the receiver operating characteristics curve or net reclassification improvement. In conclusion, the nonsignificant improvement of risk prediction does not support the clinical use of NAG ratio in cardiovascular risk assessment in a low-risk group.

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Section: Discussionsupporting

confidence: 81%

N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population

Solbu

Toft

Løchen

et al. 2016

Journal of the American Society of Nephrology

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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%

“…Urinary albumin excretion and urinary creatinine were measured with commercial kits as described previously. 22 The albumin-creatinine ratio (ACR) in mg/mmol was calculated for each urine-specimen, and the mean ACR value was used in the analyses.…”

Section: Other Measurements Including Albumin-creatinine Ratio (Acr)mentioning

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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“…20,21 Serum creatinine was measured using an enzymatic assay standardized to the isotope dilution mass spectroscopy method (CREA Plus; Roche Diagnostics, GmbH, Mannheim, Germany). Cystatin C was measured by particle-enhanced turbidimetric immunoassay (Gentian, Moss, Norway) and was calibrated to the international reference ERM-DA471/IFCC, as previously described.…”

Section: Other Measurementsmentioning

confidence: 99%

High Ambulatory Arterial Stiffness Index Is an Independent Risk Factor for Rapid Age-Related Glomerular Filtration Rate Decline in the General Middle-Aged Population

et al. 2017

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Arterial stiffness is a risk factor for cardiovascular and chronic kidney disease. However, the role of arterial stiffness as a predictor of the age-related glomerular filtration rate (GFR) decline in the general population remains unresolved because of difficulty in measuring GFR with sufficient precision in epidemiological studies. The ambulatory arterial stiffness index (AASI) is a proposed indicator of arterial stiffness easily calculated from ambulatory blood pressure. We investigated whether AASI could predict GFR decline measured as iohexol clearance in the general population. We calculated AASI from baseline ambulatory blood pressure and measured the iohexol clearance at baseline and follow-up in the RENIS-FU study (Renal Iohexol Clearance Survey Follow-Up). AASI was defined as 1 minus the regression slope of the diastolic blood pressure measurement over the systolic blood pressure measurement for each patient. The RENIS cohort included a representative sample of the general middle-aged population without baseline diabetes mellitus, cardiovascular disease, or kidney disease (n=1608). The participant age was 50 to 62 years old at baseline, and the median observation time was 5.6 years. The mean (SD) of the GFR decline rate was 0.95 mL/min per year (2.23) and that of the AASI was 0.38 mL/min per year (0.13). Baseline ambulatory blood pressure or the night/day systolic or diastolic ambulatory blood pressure ratios were not associated with GFR decline. In multivariable-adjusted linear mixed regression analysis, 1 SD of increase in the baseline AASI was associated with a 0.14 mL/min per year (95% confidence interval, −0.26 to −0.02) steeper GFR decline. We conclude that the AASI is an independent risk factor for accelerated age-related GFR decline in the general middle-aged population.

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Cardiovascular risk-factors predict progression of urinary albumin-excretion in a general, non-diabetic population

Cited by 33 publications

References 29 publications

N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population

N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population

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

High Ambulatory Arterial Stiffness Index Is an Independent Risk Factor for Rapid Age-Related Glomerular Filtration Rate Decline in the General Middle-Aged Population

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