Photo Credit: Lothar Drechsel

The following is a summary of “Prognostic impact of albuminuria in early-stage chronic kidney disease on cardiovascular outcomes: a cohort study,” published in the January 2025 issue of Cardiology by Yaqoob et al. 

Researchers conducted a retrospective study to examine the association between early-stage chronic kidney disease (CKD) (stages 1 and 2), with and without albuminuria, and the incidence of major adverse cardiovascular events (MACEs), heart failure (HF), and mortality.   

They analyzed data from 4,56,015 participants in the UK Biobank, CKD stages were determined employing an estimated glomerular filtration rate (eGFR) assessed from serum creatinine levels. Albuminuria was described as a urinary albumin-creatinine ratio ≥3 mg/mmol. Multivariable Cox proportional hazard models were operated to examine the linkage between CKD stages and cardiovascular outcomes. In a subset of participants, left ventricular mass (LVM) was assessed using cardiovascular MRI to evaluate an intermediate cardiovascular risk marker.   

The results showed the risk of adverse cardiovascular outcomes grew progressively with advancing CKD stages, except for stage 2 CKD without albuminuria. Stage 2 CKD with albuminuria was related to higher risks of MACEs (HR 1.32, 95% CI 1.25-1.38), HF (HR 1.79, 95% CI 1.67-1.92), and all-cause mortality (HR 1.51, 95% CI 1.44-1.58), comparable to stage 3A CKD without albuminuria. The presence of albuminuria interacted with the relationship between CKD stages and cardiovascular outcomes. No significant differences in indexed LVM were observed between individuals with early-stage CKD with albuminuria and those with normal renal function.   

Investigators concluded that albuminuria in early-stage CKD was independently linked with elevated risks of MACEs, HF, and mortality, emphasizing the importance of considering albuminuria alongside eGFR decline for cardiovascular risk stratification. 

Source: heart.bmj.com/content/early/2025/01/20/heartjnl-2024-324988