TY - JOUR
T1 - Albuminuria Within the "Normal" Range and Risk of Cardiovascular Disease and Death in American Indians
T2 - The Strong Heart Study
AU - Xu, Jiaqiong
AU - Knowler, William C.
AU - Devereux, Richard B.
AU - Yeh, Jeunliang
AU - Umans, Jason G.
AU - Begum, Momotaz
AU - Fabsitz, Richard R.
AU - Lee, Elisa T.
N1 - Funding Information:
Support: This study was supported by cooperative agreement grants U01-HL-41642, U01-HL-41652, and UL01-HL-41654 from the National Heart, Lung, and Blood Institute and, in part, by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases. Potential conflicts of interest: None. Original Investigation Pathogenesis and Treatment of Kidney Disease
PY - 2007/2
Y1 - 2007/2
N2 - Background: "Normal" albuminuria has been defined as urinary albumin-creatinine ratio (UACR) less than 30 mg/g (3.4 mg/mmol). Whether higher UACR within this range independently predicts cardiovascular disease (CVD) and CVD death is uncertain. Methods: A total of 3,000 participants aged 45 to 74 years with a UACR less than 30 mg/g and free of CVD at the baseline examination of the Strong Heart Study (SHS) were evaluated. Survival time was calculated from the baseline examination to the first nonfatal CVD, fatal CVD, or December 31, 2002. Results: During follow-up (average, 10.4 years), 383 incident nonfatal CVD and 145 fatal CVD cases were ascertained. After adjustment for conventional CVD risk factors, participants with a UACR in the third (UACR ≥ 5.4 to <10.2 mg/g [≥0.6 to <1.1 mg/mmol] in men, ≥7.6 to <12.9 mg/g [≥0.9 to <1.4 mg/mmol] in women) and the fourth (UACR ≥10.2 to <30 mg/g in men, ≥12.9 to <30 mg/g in women) quartiles had 41% and 72% greater risks of all CVD events and 118% and 199% greater risks of CVD mortality than those in the lowest quartile (UACR < 2.7 mg/g [<0.3 mg/mmol] in men, <4.3 mg/g [<0.5 mg/mmol] in women), respectively. In subgroup analysis, these associations were more pronounced in persons with diabetes. Conclusion: In the SHS cohort of middle-aged to elderly American Indians, albuminuria levels less than the traditional cutoff value predict CVD. Our findings agree with a growing number of studies questioning the concept that UACR less than 30 mg/g is normal.
AB - Background: "Normal" albuminuria has been defined as urinary albumin-creatinine ratio (UACR) less than 30 mg/g (3.4 mg/mmol). Whether higher UACR within this range independently predicts cardiovascular disease (CVD) and CVD death is uncertain. Methods: A total of 3,000 participants aged 45 to 74 years with a UACR less than 30 mg/g and free of CVD at the baseline examination of the Strong Heart Study (SHS) were evaluated. Survival time was calculated from the baseline examination to the first nonfatal CVD, fatal CVD, or December 31, 2002. Results: During follow-up (average, 10.4 years), 383 incident nonfatal CVD and 145 fatal CVD cases were ascertained. After adjustment for conventional CVD risk factors, participants with a UACR in the third (UACR ≥ 5.4 to <10.2 mg/g [≥0.6 to <1.1 mg/mmol] in men, ≥7.6 to <12.9 mg/g [≥0.9 to <1.4 mg/mmol] in women) and the fourth (UACR ≥10.2 to <30 mg/g in men, ≥12.9 to <30 mg/g in women) quartiles had 41% and 72% greater risks of all CVD events and 118% and 199% greater risks of CVD mortality than those in the lowest quartile (UACR < 2.7 mg/g [<0.3 mg/mmol] in men, <4.3 mg/g [<0.5 mg/mmol] in women), respectively. In subgroup analysis, these associations were more pronounced in persons with diabetes. Conclusion: In the SHS cohort of middle-aged to elderly American Indians, albuminuria levels less than the traditional cutoff value predict CVD. Our findings agree with a growing number of studies questioning the concept that UACR less than 30 mg/g is normal.
KW - Albuminuria
KW - cardiovascular disease
KW - death
KW - urinary albumin-creatinine
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U2 - 10.1053/j.ajkd.2006.10.017
DO - 10.1053/j.ajkd.2006.10.017
M3 - Article
C2 - 17261423
AN - SCOPUS:33846647004
SN - 0272-6386
VL - 49
SP - 208
EP - 216
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 2
ER -