Albuminuria predicts disease progression in patients with CKD and normoalbuminuria

The risk for chronic kidney disease (CKD) progression is higher for people with CKD and normal albuminuria, reveals a study, adding that such risk increases with higher levels of albuminuria.

A total of 1,629 participants from seven US clinical centres met the selection criteria from the Chronic Renal Insufficiency Cohort (CRIC) study with CKD (estimated glomerular filtration rate [eGFR], 20‒70 mL/min/1.73 m²) and urine albumin‒creatinine ratio (UACR) <30 mg/g.

The researchers calculated the UACR as the exposure variable by dividing the baseline spot urine albumin by the spot urine creatinine. They also measured the 10-year adjusted cumulative incidences of CKD progression (composite of 50-percent eGFR decline of kidney failure) from confounder adjusted survival curves using the G-formula.

Of the participants, 182 had CKD progression over a median follow-up of 9.8 years. The 10-year adjusted cumulative incidences of CKD progression were 8.7 percent (95 percent CI, 5.9‒11.6) for UACR levels of 0 to <5 mg/g, 11.5 percent (95 percent CI, 8.8‒14.3) for 5 to <15 mg/g, and 19.5 percent (95 percent CI, 15.4‒23.5) for 15 mg/g or more.

The absolute risk differences were 7.9 percent (95 percent CI, 3.0‒12.7) when comparing UACR ≥15 mg/g with UACR 5 to <15 mg/g and 10.7 percent (95 percent CI, 5.8‒15.6) between UACR ≥15 mg/g and UACR 0 to <5 mg/g. A linear increase was observed in the 10-year adjusted cumulative incidence based on baseline UACR levels.

“Albuminuria is a major risk factor for CKD progression, especially when categorized as moderate (30 to 300 mg/g) or severe (>300 mg/g),” the researchers said.