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Published in: Clinical and Experimental Nephrology 5/2009

01-10-2009 | Original Article

High variability of albuminuria in nondiabetic population: the Takahata Study

Authors: Kazuko Suzuki, Tsuneo Konta, Satoshi Takasaki, Ami Ikeda, Kazunobu Ichikawa, Hitoshi Sato, Yoko Shibata, Tetsu Watanabe, Takeo Kato, Sumio Kawata, Isao Kubota

Published in: Clinical and Experimental Nephrology | Issue 5/2009

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Abstract

Background

Albuminuria is a risk factor for renal and cardiovascular events and shows a quick change reflecting vascular status. The aim of this study is to examine the frequency and related factors of the short-term change of albuminuria in nondiabetic Japanese population.

Methods

The study subjects were 1,378 individuals (mean age 63.9 years) who attended community-based health checkup in 2004 and 2005 in Takahata town. Albuminuria was evaluated by urine albumin creatinine ratio in morning urine and was categorized into four stages (low normal, high normal, and micro- and macroalbuminuria).

Results

At baseline, the prevalence of subjects with low normal, high normal, and micro- and macroalbuminuria was 62.3, 17.3, 18.7, and 1.7%, respectively. During 1 year, progression and remission of albuminuria stages were observed in 23.1 and 14.5% of total subjects, respectively. Both progression and remission of albuminuria were frequently detected at every stage, especially in high normal albuminuria (29% in progression and 39% in remission, respectively). On multivariate analysis, the changes of albuminuria were associated with older age, blood pressures, total protein, estimated glomerular filtration rate (GFR), and urine sodium excretion at baseline, start of antidiabetic drugs, changes in body weight (±1 kg), hemoglobin (±1 g/dl), and urine sodium excretion (±50 mEq/day).

Conclusion

This study revealed that albuminuria showed high variability associated with age and small changes in modifiable risk factors during 1 year. In the treatment and risk analysis of subjects with albuminuria, the effect of these factors should be considered.
Literature
1.
go back to reference Deckert T, Feldt-Rasmussen B, Borch-Johnsen K, Jensen T, Kofoed-Enevoldsen A. Albuminuria reflects widespread vascular damage. The Steno hypothesis. Diabetologia. 1989;32:219–26.CrossRefPubMed Deckert T, Feldt-Rasmussen B, Borch-Johnsen K, Jensen T, Kofoed-Enevoldsen A. Albuminuria reflects widespread vascular damage. The Steno hypothesis. Diabetologia. 1989;32:219–26.CrossRefPubMed
2.
go back to reference Parving HH, Lehnert H, Bröchner-Mortensen J, Gomis R, Andersen S, Arner P. Irbesartan in patients with type 2 diabetes and Microalbuminuria Study Group. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med. 2001;345:870–8.CrossRefPubMed Parving HH, Lehnert H, Bröchner-Mortensen J, Gomis R, Andersen S, Arner P. Irbesartan in patients with type 2 diabetes and Microalbuminuria Study Group. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med. 2001;345:870–8.CrossRefPubMed
3.
go back to reference Brantsma AH, Atthobari J, Bakker SJ, de Zeeuw D, de Jong PE, Gansevoort RT. What predicts progression and regression of urinary albumin excretion in the nondiabetic population? J Am Soc Nephrol. 2007;18:637–45.CrossRefPubMed Brantsma AH, Atthobari J, Bakker SJ, de Zeeuw D, de Jong PE, Gansevoort RT. What predicts progression and regression of urinary albumin excretion in the nondiabetic population? J Am Soc Nephrol. 2007;18:637–45.CrossRefPubMed
4.
go back to reference Eijkelkamp WB, Zhang Z, Remuzzi G, Parving HH, Cooper ME, Keane WF, et al. Albuminuria is a target for renoprotective therapy independent from blood pressure in patients with type 2 diabetic nephropathy: post hoc analysis from the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) trial. J Am Soc Nephrol. 2007;18:1540–6.CrossRefPubMed Eijkelkamp WB, Zhang Z, Remuzzi G, Parving HH, Cooper ME, Keane WF, et al. Albuminuria is a target for renoprotective therapy independent from blood pressure in patients with type 2 diabetic nephropathy: post hoc analysis from the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) trial. J Am Soc Nephrol. 2007;18:1540–6.CrossRefPubMed
5.
go back to reference Pascual JM, Rodilla E, Miralles A, Gonzalez C, Redon J. Determinants of urinary albumin excretion reduction in essential hypertension: a long-term follow-up study. J Hypertens. 2006;24:2277–84.CrossRefPubMed Pascual JM, Rodilla E, Miralles A, Gonzalez C, Redon J. Determinants of urinary albumin excretion reduction in essential hypertension: a long-term follow-up study. J Hypertens. 2006;24:2277–84.CrossRefPubMed
6.
go back to reference Bello AK, de Zeeuw D, El Nahas M, Brantsma AH, Bakker SJ, de Jong PE, et al. Impact of weight change on albuminuria in the general population. Nephrol Dial Transplant. 2007;22:1619–27.CrossRefPubMed Bello AK, de Zeeuw D, El Nahas M, Brantsma AH, Bakker SJ, de Jong PE, et al. Impact of weight change on albuminuria in the general population. Nephrol Dial Transplant. 2007;22:1619–27.CrossRefPubMed
7.
go back to reference Konta T, Hao Z, Abiko H, Ishikawa M, Takahashi T, Ikeda A, et al. Prevalence and risk factor analysis of microalbuminuria in Japanese general population: the Takahata study. Kidney Int. 2006;70:751–6.CrossRefPubMed Konta T, Hao Z, Abiko H, Ishikawa M, Takahashi T, Ikeda A, et al. Prevalence and risk factor analysis of microalbuminuria in Japanese general population: the Takahata study. Kidney Int. 2006;70:751–6.CrossRefPubMed
8.
go back to reference WHO/IASO/IOTF. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia Pty Ltd.; 2000. WHO/IASO/IOTF. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia Pty Ltd.; 2000.
9.
go back to reference Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005;67:2089–100.CrossRefPubMed Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005;67:2089–100.CrossRefPubMed
10.
go back to reference Yuyun MF, Adler AI, Wareham NJ. What is the evidence that microalbuminuria is a predictor of cardiovascular disease events? Curr Opin Nephrol Hypertens. 2005;14:271–6.CrossRefPubMed Yuyun MF, Adler AI, Wareham NJ. What is the evidence that microalbuminuria is a predictor of cardiovascular disease events? Curr Opin Nephrol Hypertens. 2005;14:271–6.CrossRefPubMed
11.
go back to reference Lambers Heerspink HJ, Brinkman JW, Bakker SJ, Gansevoort RT, de Zeeuw D. Update on microalbuminuria as a biomarker in renal and cardiovascular disease. Curr Opin Nephrol Hypertens. 2006;15:631–6.CrossRefPubMed Lambers Heerspink HJ, Brinkman JW, Bakker SJ, Gansevoort RT, de Zeeuw D. Update on microalbuminuria as a biomarker in renal and cardiovascular disease. Curr Opin Nephrol Hypertens. 2006;15:631–6.CrossRefPubMed
12.
go back to reference de Jong PE, Curhan GC. Screening, monitoring, and treatment of albuminuria: public health perspectives. J Am Soc Nephrol. 2006;17:2120–6.CrossRefPubMed de Jong PE, Curhan GC. Screening, monitoring, and treatment of albuminuria: public health perspectives. J Am Soc Nephrol. 2006;17:2120–6.CrossRefPubMed
13.
go back to reference Gerstein HC, Mann JF, Yi Q, Zinman B, Dinneen SF, Hoogwerf B, et al. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA. 2001;286:421–6.CrossRefPubMed Gerstein HC, Mann JF, Yi Q, Zinman B, Dinneen SF, Hoogwerf B, et al. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA. 2001;286:421–6.CrossRefPubMed
14.
go back to reference Hillege HL, Fidler V, Diercks GF, van Gilst WH, de Zeeuw D, van Veldhuisen DJ, et al. Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population. Circulation. 2002;106:1777–82.CrossRefPubMed Hillege HL, Fidler V, Diercks GF, van Gilst WH, de Zeeuw D, van Veldhuisen DJ, et al. Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population. Circulation. 2002;106:1777–82.CrossRefPubMed
15.
go back to reference de Jong PE, Gansevoort RT, Bakker SJ. Macroalbuminuria and microalbuminuria: do both predict renal and cardiovascular events with similar strength? J Nephrol. 2007;20:375–80.PubMed de Jong PE, Gansevoort RT, Bakker SJ. Macroalbuminuria and microalbuminuria: do both predict renal and cardiovascular events with similar strength? J Nephrol. 2007;20:375–80.PubMed
16.
go back to reference Imai E, Horio M, Nitta K, Yamagata K, Iseki K, Hara S, et al. Estimation of glomerular filtration rate by the MDRD study equation modified for Japanese patients with chronic kidney disease. Clin Exp Nephrol. 2007;11:41–50.CrossRefPubMed Imai E, Horio M, Nitta K, Yamagata K, Iseki K, Hara S, et al. Estimation of glomerular filtration rate by the MDRD study equation modified for Japanese patients with chronic kidney disease. Clin Exp Nephrol. 2007;11:41–50.CrossRefPubMed
17.
go back to reference Kawasaki T, Itoh K, Uezono K, Sasaki H. A simple method for estimating 24 h urinary sodium and potassium excretion from second morning voiding urine specimen in adults. Clin Exp Pharmacol Physiol. 1993;20:7–14.CrossRefPubMed Kawasaki T, Itoh K, Uezono K, Sasaki H. A simple method for estimating 24 h urinary sodium and potassium excretion from second morning voiding urine specimen in adults. Clin Exp Pharmacol Physiol. 1993;20:7–14.CrossRefPubMed
18.
go back to reference Wachtell K, Ibsen H, Olsen MH, Borch-Johnsen K, Lindholm LH, Mogensen CE, et al. Albuminuria and cardiovascular risk in hypertensive patients with left ventricular hypertrophy: the LIFE study. Ann Intern Med. 2003;139:901–6.CrossRefPubMed Wachtell K, Ibsen H, Olsen MH, Borch-Johnsen K, Lindholm LH, Mogensen CE, et al. Albuminuria and cardiovascular risk in hypertensive patients with left ventricular hypertrophy: the LIFE study. Ann Intern Med. 2003;139:901–6.CrossRefPubMed
19.
go back to reference Verhave JC, Hillege HL, Burgerhof JG, Janssen WM, Gansevoort RT, Navis GJ, et al. Sodium intake affects urinary albumin excretion especially in overweight subjects. J Intern Med. 2004;256:324–30.CrossRefPubMed Verhave JC, Hillege HL, Burgerhof JG, Janssen WM, Gansevoort RT, Navis GJ, et al. Sodium intake affects urinary albumin excretion especially in overweight subjects. J Intern Med. 2004;256:324–30.CrossRefPubMed
20.
go back to reference Heeg JE, de Jong PE, van der Hem GK, de Zeeuw D. Efficacy and variability of the antiproteinuric effect of ACE inhibition by lisinopril. Kidney Int. 1989;36:272–9.CrossRefPubMed Heeg JE, de Jong PE, van der Hem GK, de Zeeuw D. Efficacy and variability of the antiproteinuric effect of ACE inhibition by lisinopril. Kidney Int. 1989;36:272–9.CrossRefPubMed
21.
go back to reference Dittrich S, Kurschat K, Lange PE. Abnormal rheology in cyanotic congenital heart disease—a factor in non-immune nephropathy. Scand J Urol Nephrol. 2001;35:411–5.CrossRefPubMed Dittrich S, Kurschat K, Lange PE. Abnormal rheology in cyanotic congenital heart disease—a factor in non-immune nephropathy. Scand J Urol Nephrol. 2001;35:411–5.CrossRefPubMed
22.
go back to reference Solerte SB, Fioravanti M, Pezza N, Locatelli M, Schifino N, Cerutti N, et al. Hyperviscosity and microproteinuria in central obesity: relevance to cardiovascular risk. Int J Obes Relat Metab Disord. 1997;21:417–23.CrossRefPubMed Solerte SB, Fioravanti M, Pezza N, Locatelli M, Schifino N, Cerutti N, et al. Hyperviscosity and microproteinuria in central obesity: relevance to cardiovascular risk. Int J Obes Relat Metab Disord. 1997;21:417–23.CrossRefPubMed
23.
go back to reference Brantsma AH, Bakker SJ, de Zeeuw D, de Jong PE, Gansevoort RT, PREVEND Study Group. Extended prognostic value of urinary albumin excretion for cardiovascular events. J Am Soc Nephrol. 2008;19:1785–91.CrossRefPubMedPubMedCentral Brantsma AH, Bakker SJ, de Zeeuw D, de Jong PE, Gansevoort RT, PREVEND Study Group. Extended prognostic value of urinary albumin excretion for cardiovascular events. J Am Soc Nephrol. 2008;19:1785–91.CrossRefPubMedPubMedCentral
Metadata
Title
High variability of albuminuria in nondiabetic population: the Takahata Study
Authors
Kazuko Suzuki
Tsuneo Konta
Satoshi Takasaki
Ami Ikeda
Kazunobu Ichikawa
Hitoshi Sato
Yoko Shibata
Tetsu Watanabe
Takeo Kato
Sumio Kawata
Isao Kubota
Publication date
01-10-2009
Publisher
Springer Japan
Published in
Clinical and Experimental Nephrology / Issue 5/2009
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-009-0177-3

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