How does proteinuria affect cardiovascular outcomes?

Updated: Mar 25, 2020
  • Author: Beje Thomas, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

In a study of 2310 patients, Jackson et al concluded that spot urinary albumin-to-creatinine ratios (UACRs) have significant prognostic value in persons with heart failure. [20] These authors determined that, compared with patients with normoalbuminuria, those with an elevated UACR tended to be older, had higher rates of cardiovascular comorbidity and diabetes mellitus, and suffered from worse renal function. Even after adjustment for variables such as renal function and diabetes, an increased UACR was associated with a greater mortality risk.

In the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) population study, the incidence of myocardial infarction was higher in patients with microalbuminuria than in those with normal urinary albumin levels. [21] In a study by Rein et al, albuminuria was an important predictor of cardiovascular mortality even after adjusting for conventional risk factors. [22] Analysis of 1208 hypertensive, normoalbuminuric patients with type 2 diabetes from the BENEDICT trial also showed increased cardiovascular problems with any degree of measurable urinary albumin. [23]


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