Proteinuria or Albuminuria as Markers of Kidney and Cardiovascular Disease Risk : An Individual Patient-Level Meta-analysis.
| Title: | Proteinuria or Albuminuria as Markers of Kidney and Cardiovascular Disease Risk : An Individual Patient-Level Meta-analysis. |
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| Authors: | Hiddo JL Heerspink; Morgan E Grams; Yingying Sang; Shoshana H Ballew; Josef Coresh; Aditya Surapaneni; Natalia Alencar de Pinho; Nigel Brunskill; Alexander R Chang; Elizabeth Ciemins; Laura M Dember; Keiko Kabasawa; Lindsey Kornowske; Adeera Levin; Rupert Major; Patrick B Mark; Eric McArthur; James Medcalf; Marie Metzger; Girish N Nadkarni; David MJ Naimark; Cassianne Robinson-Cohen; Keiichi Sumida; Robin WM Vernooij; Ron T Gansevoort; Bengt Fellström; Steven Chadban; CKD Prognosis Consortium |
| Publication Year: | 2025 |
| Collection: | University of Leicester: Figshare |
| Subject Terms: | Biomedical and clinical sciences; Clinical sciences; Humans; Albuminuria; Proteinuria; Cardiovascular Diseases; Biomarkers; Creatinine; Renal Insufficiency; Chronic; Glomerular Filtration Rate; Female; Male; Middle Aged; Diabetes Mellitus; Type 2; Risk Factors |
| Description: | BACKGROUND: Urinary albumin-creatinine ratio (UACR) and urinary protein-creatinine ratio (UPCR) are both used in clinical practice to diagnose and monitor chronic kidney disease (CKD). Which measure exhibits stronger associations with clinical outcomes and whether this varies by patient characteristics are unknown. OBJECTIVE: To assess and compare the performance of UACR and UPCR across CKD-related clinical outcomes. DESIGN: Individual patient-level meta-analysis. SETTING: 38 research and clinical cohorts. PARTICIPANTS: 148 994 participants with same-day measurements of UACR and UPCR. MEASUREMENTS: We quantified the associations of UACR and UPCR with subsequent clinical outcomes, including kidney failure and cardiovascular events, using Cox proportional hazards regression. Analyses were done in each cohort, followed by random-effects meta-analysis. Subgroups included those based on severity of proteinuria, type 2 diabetes, estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2, and glomerular disease. RESULTS: There were 148 994 participants and 9773 kidney failure events during a median of 3.8 years of follow-up. Higher UACR and UPCR both had a log-linear association with increased risk for kidney failure. The association with kidney failure was somewhat stronger for UACR (adjusted hazard ratio [HR] per SD increment, 2.55 [95% CI, 2.36 to 2.74]) than UPCR (HR, 2.40 [CI, 2.28 to 2.53]; P for comparison |
| Document Type: | article in journal/newspaper |
| Language: | unknown |
| Relation: | 2381/31676542.v1 |
| Availability: | https://figshare.com/articles/journal_contribution/Proteinuria_or_Albuminuria_as_Markers_of_Kidney_and_Cardiovascular_Disease_Risk_An_Individual_Patient-Level_Meta-analysis_/31676542 |
| Rights: | CC BY 4.0 |
| Accession Number: | edsbas.158B4E4B |
| Database: | BASE |