High risks of all-cause and cardiovascular deaths in apparently healthy middle-aged people with preserved glomerular filtration rate and albuminuria: A prospective cohort study

Masaki Ohsawa, Tomoaki Fujioka, Kuniaki Ogasawara, Kozo Tanno, Tomonori Okamura, Tanvir Chowdhury Turin, Kazuyoshi Itai, Akira Ogawa, Yuki Yoshida, Shinichi Omama, Toshiyuki Onoda, Motoyuki Nakamura, Shinji Makita, Yasuhiro Ishibashi, Fumitaka Tanaka, Toru Kuribayashi, Mutsuko Ohta, Kiyomi Sakata, Akira Okayama

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Abstract

Background The reason why coexistence of preserved estimated glomerular filtration rate (eGFR) and albuminuria contributes to a high risk of death and which cause of death increases all-cause mortality have not been elucidated. Methods A total of 16,759 participants aged 40 to 69 years with normal or mildly reduced eGFR (45-119 ml/min/1.73 m2) were enrolled and divided into six groups (group 1, eGFR: 90-119 without albuminuria; group 2, eGFR: 90-119 with albuminuria; group 3, eGFR: 60-89 without albuminuria (reference); group 4, eGFR: 60-89 with albuminuria; group 5, eGFR: 45-59 without albuminuria; group 6, eGFR: 45-59 with albuminuria) based on GFR estimated by using the CKD-EPI study equation modified by a Japanese coefficient and albuminuria (urine albumin-creatinine ratio ≥ 30 mg/g). Outcomes included all-cause death (ACD), cardiovascular death (CVD) and neoplasm-related death (NPD). Multivariable-adjusted mortality rate ratios (RR) and their 95% confidence intervals (CIs) in the groups were estimated by Poisson's regression analysis. Results The highest risk of ACD (RR (95% CIs): 3.95 (2.08-7.52)), CVD (7.15 (2.25-22.7)) and NPB (3.25 (1.26-8.38)) was observed in group 2. Subjects in group 2 were relatively young and had the highest levels of body mass index, blood pressure and HbA1c and the highest prevalence of diabetes and metabolic syndrome. Conclusion Coexistence of preserved eGFR and albuminuria increases risks for ACD, CVD and NPD. Relatively young metabolic persons having both preserved eGFR and albuminuria should be considered as a very high-risk population.

Original languageEnglish
Pages (from-to)167-172
Number of pages6
JournalInternational Journal of Cardiology
Volume170
Issue number2
DOIs
Publication statusPublished - 2013 Dec 10

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Keywords

  • Albuminuria
  • Chronic kidney disease
  • Estimated glomerular filtration rate
  • Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Ohsawa, M., Fujioka, T., Ogasawara, K., Tanno, K., Okamura, T., Turin, T. C., Itai, K., Ogawa, A., Yoshida, Y., Omama, S., Onoda, T., Nakamura, M., Makita, S., Ishibashi, Y., Tanaka, F., Kuribayashi, T., Ohta, M., Sakata, K., & Okayama, A. (2013). High risks of all-cause and cardiovascular deaths in apparently healthy middle-aged people with preserved glomerular filtration rate and albuminuria: A prospective cohort study. International Journal of Cardiology, 170(2), 167-172. https://doi.org/10.1016/j.ijcard.2013.10.076