Very low-grade albuminuria reflects susceptibility to chronic kidney disease in combination with cardiovascular risk factors

Abstract

Low-grade albuminuria has been proposed as a cardiovascular risk factor that is below the conventional cut-off point for microalbuminuria, which has been previously identified as a marker for cardiovascular disease and chronic kidney disease (CKD). Metabolic syndrome has also been shown to be related with microalbuminuria and CKD. We assessed the relationship among low-grade albuminuria, CKD and metabolic syndrome among 5998 non-diabetic subjects. The subjects were divided into six groups: subjects with urine albumin-to-creatinine ratio (UACR) o30 mg g À1 were divided into five groups in accordance with their UACR values, and subjects with 30pUACR o300 mg g À1 were allocated to the microalbuminuria group. The prevalence of CKD increased in parallel with increasing UACR values and greater numbers of metabolic syndrome characteristics, which were in turn associated with a reduced UACR cut-off point for an increased prevalence of CKD. Among the subjects with metabolic syndrome, UACR values above 10.2 mg g À1 were related to increased CKD prevalence (odds ratio (OR): 2.63, 95% confidence interval (CI) 1.11-6.24), as were values of 30 mg g À1 among those with 1 or 2 components of metabolic syndrome (OR: 2.98, 95% CI 1.83-4.83); elevated UACR was not observed to increase the risk of CKD in subjects who had no components of metabolic syndrome. The cut-off point varied in subjects with various cardiovascular risk profiles such as serum uric acid level, gender or hypertension. Very low levels of albuminuria were associated with increased CKD prevalence. The UACR cut-off point for increased CKD risk varied according to the risk profile, including the number of metabolic syndrome components.

Detection of Lower Albuminuria Levels and Early Development of Diabetic Kidney Disease Using an Artificial Intelligence-Based Rule Extraction Approach

“…The prevalence of CKD increased with increasing UACR values and greater numbers of metabolic syndrome characteristics [16]. This, in turn, was associated with a decreased UACR cut-off point and the increased prevalence of CKD.…”

“…To date, many studies have reported UACR cut-off values for diseases that are associated with diabetic diabetes, e.g., MA cut-offs of 19.25 mg/g Cr [19] for hypertension; 10.7 mg/g Cr [20], 15.6 mg/g Cr [21], 10.7 mg/g Cr [22], and 10.0 mg/g Cr [23] for diabetic retinopathy (DR); and 4.8 mg/g Cr [6] for metabolic syndrome. However, only four studies that investigated the cut-off values for type 2 diabetes [15], CKD [16], and DN [17,18] have been conducted.…”

“…The values of 3.89 and 4.8 mg/g Cr in those two studies were relatively close to the value of 6.1 mg/g Cr that was found in the present study. Heo et al [16] reported that UACR values above 10.2 mg/g Cr were associated with an increased prevalence of CKD among individuals with metabolic syndrome.…”

Metabolic syndrome and its components are associated with increased chronic kidney disease risk: Evidence from a meta-analysis on 11 109 003 participants from 66 studies

“…[81][82][83] A total of 66 studies, comprising 699 065 CKD patients and 11 109 003 participants, were finally included in the meta-analysis. Among the included studies, 43 were from the East Asian populations 8,9,[22][23][24][25][27][28][29]33,[35][36][37][38][39][40][41]43,44,51,52,[55][56][57][58][59]62,[65][66][67]69,[71][72][73][74][75][76][77][78][79][80]82,83 and 23 were from non-East Asian populations. 12,20,21,26,[30...…”

Possible Link between Metabolic Syndrome and Chronic Kidney Disease in the Development of Cardiovascular Disease

“…Palaniappan et al demonstrated a higher rate of microalbuminuria in men and women with MetS than in healthy controls [20]. The cutoff point of the urinary albumin-to-creatinine ratio varied in subjects with various CVD risk profiles, and even low-grade albuminuria below the conventional cutoff point for microalbuminuria was associated with increased prevalence of CKD [21]. Kurella et al performed a longitudinal cohort study and found a higher rate of CKD in MetS even after adjustment for subsequent development of diabetes and hypertension, suggesting that MetS is independently associated with an increased risk for incident CKD in nondiabetic adults [22].…”