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CKD Progression Risk Up With Increasing Albuminuria in Normal Range – Renal and Urology News

(HealthDay News) — For people with chronic kidney disease (CKD) and normoalbuminuria, the risk for CKD progression increases with higher levels of albuminuria, according to a study published online in the Annals of Internal Medicine.

Ashish Verma, MB, BS, from the Boston University Chobanian & Avedisian School of Medicine, and colleagues estimated the increase in the cumulative incidence of CKD progression with higher baseline levels of albuminuria among persons with CKD who had normoalbuminuria (<30 mg/g) in a multicenter prospective study. Data were included for 1629 participants meeting criteria from the Chronic Renal Insufficiency Cohort study with CKD and a urine albumin-creatinine ratio (UACR) <30 mg/g.

The researchers found that 182 of the participants experienced CKD progression during a median follow-up of 9.8 years. For UACR levels of 0 to <5, 5 to <15, and ≥15 mg/g, the 10-year adjusted cumulative incidences of CKD progression were 8.7%, 11.5%, and 19.5%, respectively. The absolute risk differences were 7.9% and 10.7% comparing persons with UACR ≥15 mg/g to those with UACR of 5 to <15 and 0 to <5 mg/g, respectively. There was a linear increase observed in 10-year adjusted cumulative incidence based on baseline UACR levels.

“These findings underscore the need for future studies to determine the optimal threshold for initiating treatment with antiproteinuric agents and whether the further reduction in albuminuria may improve adverse clinical outcomes in persons with CKD who have normoalbuminuria,” the authors write.

References:

Verma A, Schmidt IM, Claudel S, Palsson R, Waikar SS, Srivastava A. Association of Albuminuria With Chronic Kidney Disease Progression in Persons With Chronic Kidney Disease and Normoalbuminuria : A Cohort Study. Ann Intern Med. 2024 Apr 2. doi:10.7326/M23-2814