Prognostic impact of albuminuria in early-stage chronic kidney disease on cardiovascular outcomes: a cohort study
Authors' conclusion
In early-stage CKD, albuminuria is independently associated with increased risks of MACE, HF and mortality. These findings support the use of albuminuria over eGFR decline alone for cardiovascular risk stratification in early CKD.
Study context
- Population
- Participants from the UK Biobank categorised by chronic kidney disease (CKD) stage (estimated glomerular filtration rate (eGFR) from serum creatinine; albuminuria defined as urinary albumin-creatinine ratio ≥3 mg/mmol)participants from the UK Biobank, left ventricular mass (LVM) assessed in a subset by cardiovascular MRI
- Participants
- 456,015 participants
- Exposure
- Early CKD (stages 1 and 2) with and without albuminuria compared with normal kidney function
- Outcome
- Risk of adverse outcomes across CKD stages
Methodological detailsUK Biobank, Multivariable Cox proportional hazard models
- UK Biobank
- Multivariable Cox proportional hazard models
Main finding
As reported in the abstract
- Risk increased progressively with advancing CKD stages, except for stage 2 CKD without albuminuria
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| MACE, HF and all-cause mortalityStage 2 CKD with albuminuriavs normal kidney functionMACE | 1.32 (1.25–1.38) | |
| MACE, HF and all-cause mortalityStage 2 CKD with albuminuriavs normal kidney functionHF | 1.79 (1.67–1.92) | |
| MACE, HF and all-cause mortalityStage 2 CKD with albuminuriavs normal kidney functionAll-cause mortality | 1.51 (1.44–1.58) | |
| 0.512Hazard ratio (log scale) |
- MACE, heart failure (HF) and all-cause mortality: comparable to stage 3A CKD without albuminuria
Interaction of albuminuria with CKD stage–outcome relationships
- The presence of albuminuria significantly interacted with the relationships between CKD stages and outcomes
Indexed LVM (cardiovascular MRI subset)
- No significant differences in indexed LVM between early-stage CKD with albuminuria and normal renal function
Original publication
Prognostic impact of albuminuria in early-stage chronic kidney disease on cardiovascular outcomes: a cohort study. Heart. Published 20 January 2025. doi:10.
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