What is the evidence that microalbuminuria is a predictor of cardiovascular disease events?

Abstract

Future absolute risk prediction scores for primary cardiovascular events could include microalbuminuria as a modifiable risk factor. The association between levels of albuminuria and cardiovascular outcomes in individuals within the normoalbuminuric range questions the current categorical definition of microalbuminuria. Intensive multifactorial interventions, including the use of agents that affect the renin-angiotensin pathway, are effective in reducing cardiovascular risk in patients with microalbuminuria and diabetes or hypertension.

Association of D-dimer with microalbuminuria in patients with type 2 diabetes mellitus

“…We used 20 lg/min as a cut-off value to separate microalbuminuria from normoalbuminuria, and this cutoff point has been used in most studies [26]. However, recent evidence indicates that urinary cut-off points below 20 lg/min also predict cardiovascular disease outcomes in both diabetic and non-diabetic populations [33]. A recent study has shown that AER over 4.8 lg/min was associated with a significantly two-fold increased risk of coronary heart disease [34].…”

High variability of albuminuria in nondiabetic population: the Takahata Study

“…The intra-and interassay coefficients of variation were 0.5-0.9% and 0.6-1.3%, respectively. To evaluate urinary albumin excretion in general population by UACR, it is strongly recommended to use gender-specific cutoff values because the difference in urine creatinine excretion between men and women might misclassify the levels of albuminuria [9][10][11][12]. Furthermore, several epidemiological studies have revealed that, even within the normal range of albuminuria, the increase of UACR is related with higher risk of cardiovascular diseases [13,14].…”

Differences in determinants of left ventricular mass assessed by cardiac magnetic resonance imaging across subjects with and without previous symptomatic atherosclerotic disease

“…Subjects who currently used alcohol, or had done so in the past were classified as alcohol drinkers. Albuminuria was defined as a urinary albumin:creatinine ratio greater than 2.5 mg/mmol for men or greater than 3.5 mg/mmol for women [14].…”