Albuminuria is an independent predictor of all-cause and cardiovascular mortality in the Japanese population: the Takahata study

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• 作者：Tsuneo Konta (1)
  Kosuke Kudo (1)
  Hiroko Sato (1)
  Kazunobu Ichikawa (1)
  Ami Ikeda (1)
  Kazuko Suzuki (1)
  Atsushi Hirayama (1)
  Yoko Shibata (1)
  Tetsu Watanabe (1)
  Makoto Daimon (2)
  Takeo Kato (2)
  Yoshiyuki Ueno (2)
  Takamasa Kayama (2)
  Isao Kubota (1)
  
• 关键词：Albuminuria ; Mortality ; Population ; Cohort
• 刊名：Clinical and Experimental Nephrology
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：17
• 期：6
• 页码：805-810
• 全文大小：
• 作者单位：Tsuneo Konta (1)
  Kosuke Kudo (1)
  Hiroko Sato (1)
  Kazunobu Ichikawa (1)
  Ami Ikeda (1)
  Kazuko Suzuki (1)
  Atsushi Hirayama (1)
  Yoko Shibata (1)
  Tetsu Watanabe (1)
  Makoto Daimon (2)
  Takeo Kato (2)
  Yoshiyuki Ueno (2)
  Takamasa Kayama (2)
  Isao Kubota (1)
  
  1. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
  2. Global COE, Yamagata University School of Medicine, Yamagata, Japan
  
• ISSN：1437-7799

文摘

Background Albuminuria is a known risk factor for cardiovascular events and premature deaths. However, the association between urinary albumin excretion and mortality is unknown in the Japanese population. To clarify this, we conducted a community-based longitudinal study. Methods This study included 3,445 registered Japanese subjects (mean age 62.6years), with a 7-year follow-up. Albuminuria was defined as a urine albumin-creatinine ratio (ACR)0mg/g in the morning spot urine. Results Subjects with albuminuria (n=514, 14.9%) were older and showed a higher prevalence of hypertension, obesity, and diabetes and lower values of estimated glomerular filtration rate (eGFR) than those without albuminuria (n=2931, 85.1%). During the follow-up, 138 subjects died. A Kaplaneier analysis showed that all-cause mortality significantly increased along with the increase in urine albumin excretion (log-rank test, P<0.001). The subjects with albuminuria showed a significantly higher mortality rate than those without albuminuria (7.4 vs. 3.4%; log-rank test, P<0.001). A Cox proportional hazard model analysis after adjusting for possible confounders showed that albuminuria was an independent risk factor for all-cause and cardiovascular mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.12.56 and HR 2.27, 95% CI 1.10.70, respectively) but not for noncardiovascular mortality. These associations were preserved after excluding subjects with high ACR (00mg/g). Conclusions Albuminuria was a risk factor for all-cause and cardiovascular mortality in the Japanese population. To detect subjects with a high risk for premature death, measuring urinary albumin excretion might be useful.