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Published in: Clinical and Experimental Nephrology 4/2018

01-08-2018 | Original Article

High-normal albuminuria and incident chronic kidney disease in a male nondiabetic population

Authors: Aki Ashitani, Toshinori Ueno, Ayumu Nakashima, Shigehiro Doi, Kiminori Yamane, Takao Masaki

Published in: Clinical and Experimental Nephrology | Issue 4/2018

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Abstract

Background

High-normal albuminuria is an important risk factor for incident chronic kidney disease in diabetic populations, in contrast to an uncertain association in nondiabetic populations. This study aimed to reveal the relationship between high-normal albuminuria and incident chronic kidney disease in a Japanese nondiabetic population.

Methods

A 10-year follow-up retrospective cohort study was performed involving 1378 Japanese men (mean age 44 ± 5.3 years) without chronic kidney disease and diabetes mellitus. Chronic kidney disease was diagnosed as either estimated glomerular filtration rate < 60 mL/min/1.73 m2 or a urine albumin-to-creatinine ratio ≥ 30 mg/g.

Results

At baseline, age, estimated glomerular filtration rate, and the presence of hematuria, hypertension, and dyslipidemia were independently associated with the albumin-to-creatinine ratio. Among the 1378 participants, 185 (13.4%) fulfilled diagnostic criteria for chronic kidney disease over the 10-year follow-up period. Median annual estimated glomerular filtration rate decline showed a deterioration with increasing quartiles of baseline albumin-to-creatinine ratio (P = 0.004). Participants who had a baseline albumin-to-creatinine ratio in the highest quartile (5.9–28.9 mg/g) were more likely to develop micro- or macroalbuminuria (odds ratio: 16.23, 95% confidence interval 6.56–54.03), chronic kidney disease (odds ratio: 2.48, 95% confidence interval 1.64–3.82), and hypertension (odds ratio 2.06, 95% confidence interval 1.30–3.31), but not diabetes mellitus compared with those who had an albumin-to-creatinine ratio in the lowest quartile (1.3–3.6 mg/g) after adjustment for potential confounders.

Conclusions

High-normal albuminuria was associated with incident chronic kidney disease in this Japanese nondiabetic male population.
Literature
1.
go back to reference Eckardt KU, Coresh J, Devuyst O, et al. Evolving importance of kidney disease: from subspecialty to global health burden. Lancet. 2013;382:158–69.CrossRefPubMed Eckardt KU, Coresh J, Devuyst O, et al. Evolving importance of kidney disease: from subspecialty to global health burden. Lancet. 2013;382:158–69.CrossRefPubMed
2.
go back to reference Kerr M, Bray B, Medcalf J, et al. Estimating the financial cost of chronic kidney disease to the NHS in England. Nephrol Dial Transplant. 2012;27(Suppl 3):iii73–i80.CrossRefPubMedPubMedCentral Kerr M, Bray B, Medcalf J, et al. Estimating the financial cost of chronic kidney disease to the NHS in England. Nephrol Dial Transplant. 2012;27(Suppl 3):iii73–i80.CrossRefPubMedPubMedCentral
3.
go back to reference Travers K, Martin A, Khankhel Z, et al. Burden and management of chronic kidney disease in Japan: systematic review of the literature. Int J Nephrol Renovasc Dis. 2013;6:1–13.CrossRefPubMedPubMedCentral Travers K, Martin A, Khankhel Z, et al. Burden and management of chronic kidney disease in Japan: systematic review of the literature. Int J Nephrol Renovasc Dis. 2013;6:1–13.CrossRefPubMedPubMedCentral
4.
go back to reference Detlef Schlondorff KDIGO 2012. Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3:1–150.CrossRef Detlef Schlondorff KDIGO 2012. Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3:1–150.CrossRef
5.
go back to reference Association AD. Standards of medical care in diabetes. Diabetes Care. 2005;28(Suppl 1):S4–36.CrossRef Association AD. Standards of medical care in diabetes. Diabetes Care. 2005;28(Suppl 1):S4–36.CrossRef
6.
go back to reference Bakris GL, Molitch M. Microalbuminuria as a risk predictor in diabetes: the continuing saga. Diabetes Care. 2014;37:867–75.CrossRefPubMed Bakris GL, Molitch M. Microalbuminuria as a risk predictor in diabetes: the continuing saga. Diabetes Care. 2014;37:867–75.CrossRefPubMed
8.
go back to reference Halbesma N, Jansen DF, Heymans MW, et al. Development and validation of a general population renal risk score. Clin J Am Soc Nephrol. 2011;6:1731–8.CrossRefPubMed Halbesma N, Jansen DF, Heymans MW, et al. Development and validation of a general population renal risk score. Clin J Am Soc Nephrol. 2011;6:1731–8.CrossRefPubMed
9.
go back to reference Retnakaran R, Cull CA, Thorne KI, et al. Risk factors for renal dysfunction in type 2 diabetes: U.K. Prospective Diabetes Study 74. Diabetes. 2006;55:1832–9.CrossRefPubMed Retnakaran R, Cull CA, Thorne KI, et al. Risk factors for renal dysfunction in type 2 diabetes: U.K. Prospective Diabetes Study 74. Diabetes. 2006;55:1832–9.CrossRefPubMed
10.
go back to reference Klausen K, Borch-Johnsen K, Feldt-Rasmussen B, et al. Very low levels of microalbuminuria are associated with increased risk of coronary heart disease and death independently of renal function, hypertension, and diabetes. Circulation. 2004;110:32–5.CrossRefPubMed Klausen K, Borch-Johnsen K, Feldt-Rasmussen B, et al. Very low levels of microalbuminuria are associated with increased risk of coronary heart disease and death independently of renal function, hypertension, and diabetes. Circulation. 2004;110:32–5.CrossRefPubMed
11.
go back to reference Matsushita K, van der Velde M, Astor BC, et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375:2073–81.CrossRefPubMedPubMedCentral Matsushita K, van der Velde M, Astor BC, et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375:2073–81.CrossRefPubMedPubMedCentral
12.
go back to reference Nitsch D, Grams M, Sang Y, et al. Associations of estimated glomerular filtration rate and albuminuria with mortality and renal failure by sex: a meta-analysis. BMJ. 2013;346:f324.CrossRefPubMedPubMedCentral Nitsch D, Grams M, Sang Y, et al. Associations of estimated glomerular filtration rate and albuminuria with mortality and renal failure by sex: a meta-analysis. BMJ. 2013;346:f324.CrossRefPubMedPubMedCentral
13.
go back to reference Association AD. Erratum. Classification and diagnosis of diabetes. Section 2. In Standards of Medical Care in Diabetes-2016. Diabetes Care. 2016;39(Suppl 1):S13–22 (Diabetes Care. 2016;39:1653). Association AD. Erratum. Classification and diagnosis of diabetes. Section 2. In Standards of Medical Care in Diabetes-2016. Diabetes Care. 2016;39(Suppl 1):S13–22 (Diabetes Care. 2016;39:1653).
14.
go back to reference James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–20.CrossRefPubMed James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–20.CrossRefPubMed
15.
go back to reference Kashiwagi A, Kasuga M, Araki E, et al. International clinical harmonization of glycated hemoglobin in Japan: From Japan Diabetes Society to National Glycohemoglobin Standardization Program values. J Diabetes Investig. 2012;3:39–40.CrossRefPubMedPubMedCentral Kashiwagi A, Kasuga M, Araki E, et al. International clinical harmonization of glycated hemoglobin in Japan: From Japan Diabetes Society to National Glycohemoglobin Standardization Program values. J Diabetes Investig. 2012;3:39–40.CrossRefPubMedPubMedCentral
16.
go back to reference Matsuo S, Imai E, Horio M, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.CrossRefPubMed Matsuo S, Imai E, Horio M, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.CrossRefPubMed
17.
go back to reference Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.PubMed Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.PubMed
18.
go back to reference National Cholesterol Education Program (NCEP). Expert panel on detection Ea, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–421.CrossRef National Cholesterol Education Program (NCEP). Expert panel on detection Ea, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–421.CrossRef
19.
go back to reference Okamura T, Tanaka H, Miyamatsu N, et al. The relationship between serum total cholesterol and all-cause or cause-specific mortality in a 17.3-year study of a Japanese cohort. Atherosclerosis. 2007;190:216–23.CrossRefPubMed Okamura T, Tanaka H, Miyamatsu N, et al. The relationship between serum total cholesterol and all-cause or cause-specific mortality in a 17.3-year study of a Japanese cohort. Atherosclerosis. 2007;190:216–23.CrossRefPubMed
20.
go back to reference Loeb JN. The influence of temperature on the solubility of monosodium urate. Arthritis Rheum. 1972;15:189–92.CrossRefPubMed Loeb JN. The influence of temperature on the solubility of monosodium urate. Arthritis Rheum. 1972;15:189–92.CrossRefPubMed
21.
go back to reference Fox CS, Larson MG, Leip EP, et al. Predictors of new-onset kidney disease in a community-based population. JAMA. 2004;291:844–50.CrossRefPubMed Fox CS, Larson MG, Leip EP, et al. Predictors of new-onset kidney disease in a community-based population. JAMA. 2004;291:844–50.CrossRefPubMed
22.
go back to reference Yamagata K, Ishida K, Sairenchi T, et al. Risk factors for chronic kidney disease in a community-based population: a 10-year follow-up study. Kidney Int. 2007;71:159–66.CrossRefPubMed Yamagata K, Ishida K, Sairenchi T, et al. Risk factors for chronic kidney disease in a community-based population: a 10-year follow-up study. Kidney Int. 2007;71:159–66.CrossRefPubMed
23.
go back to reference Forman JP, Fisher ND, Schopick EL, et al. Higher levels of albuminuria within the normal range predict incident hypertension. J Am Soc Nephrol. 2008;19:1983–8.CrossRefPubMedPubMedCentral Forman JP, Fisher ND, Schopick EL, et al. Higher levels of albuminuria within the normal range predict incident hypertension. J Am Soc Nephrol. 2008;19:1983–8.CrossRefPubMedPubMedCentral
24.
go back to reference Jessani S, Levey AS, Chaturvedi N, et al. High normal levels of albuminuria and risk of hypertension in Indo-Asian population. Nephrol Dial Transplant. 2012;27(Suppl 3):iii58–i64.CrossRefPubMed Jessani S, Levey AS, Chaturvedi N, et al. High normal levels of albuminuria and risk of hypertension in Indo-Asian population. Nephrol Dial Transplant. 2012;27(Suppl 3):iii58–i64.CrossRefPubMed
25.
go back to reference Ballermann BJ, Stan RV. Resolved: capillary endothelium is a major contributor to the glomerular filtration barrier. J Am Soc Nephrol. 2007;18:2432–8.CrossRefPubMed Ballermann BJ, Stan RV. Resolved: capillary endothelium is a major contributor to the glomerular filtration barrier. J Am Soc Nephrol. 2007;18:2432–8.CrossRefPubMed
26.
go back to reference Rabelink TJ, de Zeeuw D. The glycocalyx-linking albuminuria with renal and cardiovascular disease. Nat Rev Nephrol. 2015;11:667–76.CrossRefPubMed Rabelink TJ, de Zeeuw D. The glycocalyx-linking albuminuria with renal and cardiovascular disease. Nat Rev Nephrol. 2015;11:667–76.CrossRefPubMed
27.
go back to reference Clausen P, Jensen JS, Jensen G, et al. Elevated urinary albumin excretion is associated with impaired arterial dilatory capacity in clinically healthy subjects. Circulation. 2001;103:1869–74.CrossRefPubMed Clausen P, Jensen JS, Jensen G, et al. Elevated urinary albumin excretion is associated with impaired arterial dilatory capacity in clinically healthy subjects. Circulation. 2001;103:1869–74.CrossRefPubMed
28.
go back to reference Dogra G, Rich L, Stanton K, et al. Endothelium-dependent and independent vasodilation studies at normoglycaemia in type I diabetes mellitus with and without microalbuminuria. Diabetologia. 2001;44:593–601.CrossRefPubMed Dogra G, Rich L, Stanton K, et al. Endothelium-dependent and independent vasodilation studies at normoglycaemia in type I diabetes mellitus with and without microalbuminuria. Diabetologia. 2001;44:593–601.CrossRefPubMed
29.
go back to reference Clausen P, Feldt-Rasmussen B, Jensen G, et al. Endothelial haemostatic factors are associated with progression of urinary albumin excretion in clinically healthy subjects: a 4-year prospective study. Clin Sci (Lond). 1999;97:37–43.CrossRef Clausen P, Feldt-Rasmussen B, Jensen G, et al. Endothelial haemostatic factors are associated with progression of urinary albumin excretion in clinically healthy subjects: a 4-year prospective study. Clin Sci (Lond). 1999;97:37–43.CrossRef
30.
go back to reference Martens RJ, Henry RM, Houben AJ, et al. Capillary rarefaction associates with albuminuria: the Maastricht Study. J Am Soc Nephrol. 2016;27(12):3748–57.CrossRefPubMedPubMedCentral Martens RJ, Henry RM, Houben AJ, et al. Capillary rarefaction associates with albuminuria: the Maastricht Study. J Am Soc Nephrol. 2016;27(12):3748–57.CrossRefPubMedPubMedCentral
31.
go back to reference Pinto-Sietsma SJ, Janssen WM, Hillege HL, et al. Urinary albumin excretion is associated with renal functional abnormalities in a nondiabetic population. J Am Soc Nephrol. 2000;11:1882–8.PubMed Pinto-Sietsma SJ, Janssen WM, Hillege HL, et al. Urinary albumin excretion is associated with renal functional abnormalities in a nondiabetic population. J Am Soc Nephrol. 2000;11:1882–8.PubMed
32.
go back to reference Nangaku M, Pippin J, Couser WG. C6 mediates chronic progression of tubulointerstitial damage in rats with remnant kidneys. J Am Soc Nephrol. 2002;13:928–36.PubMed Nangaku M, Pippin J, Couser WG. C6 mediates chronic progression of tubulointerstitial damage in rats with remnant kidneys. J Am Soc Nephrol. 2002;13:928–36.PubMed
33.
go back to reference Zoja C, Benigni A, Remuzzi G. Cellular responses to protein overload: key event in renal disease progression. Curr Opin Nephrol Hypertens. 2004;13:31–7.CrossRefPubMed Zoja C, Benigni A, Remuzzi G. Cellular responses to protein overload: key event in renal disease progression. Curr Opin Nephrol Hypertens. 2004;13:31–7.CrossRefPubMed
34.
go back to reference Brantsma AH, Atthobari J, Bakker SJ, et al. 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, et al. What predicts progression and regression of urinary albumin excretion in the nondiabetic population? J Am Soc Nephrol. 2007;18:637–45.CrossRefPubMed
35.
go back to reference Suzuki K, Konta T, Takasaki S, et al. High variability of albuminuria in nondiabetic population: the Takahata Study. Clin Exp Nephrol. 2009;13:452–9.CrossRefPubMed Suzuki K, Konta T, Takasaki S, et al. High variability of albuminuria in nondiabetic population: the Takahata Study. Clin Exp Nephrol. 2009;13:452–9.CrossRefPubMed
36.
go back to reference Vivante A, Afek A, Frenkel-Nir Y, et al. Persistent asymptomatic isolated microscopic hematuria in Israeli adolescents and young adults and risk for end-stage renal disease. JAMA. 2011;306:729–36.CrossRefPubMed Vivante A, Afek A, Frenkel-Nir Y, et al. Persistent asymptomatic isolated microscopic hematuria in Israeli adolescents and young adults and risk for end-stage renal disease. JAMA. 2011;306:729–36.CrossRefPubMed
37.
go back to reference Gutiérrez E, González E, Hernández E, et al. Factors that determine an incomplete recovery of renal function in macrohematuria-induced acute renal failure of IgA nephropathy. Clin J Am Soc Nephrol. 2007;2:51–7.CrossRefPubMed Gutiérrez E, González E, Hernández E, et al. Factors that determine an incomplete recovery of renal function in macrohematuria-induced acute renal failure of IgA nephropathy. Clin J Am Soc Nephrol. 2007;2:51–7.CrossRefPubMed
38.
go back to reference Naresh CN, Hayen A, Weening A, et al. Day-to-day variability in spot urine albumin–creatinine ratio. Am J Kidney Dis. 2013;62:1095–101.CrossRefPubMed Naresh CN, Hayen A, Weening A, et al. Day-to-day variability in spot urine albumin–creatinine ratio. Am J Kidney Dis. 2013;62:1095–101.CrossRefPubMed
Metadata
Title
High-normal albuminuria and incident chronic kidney disease in a male nondiabetic population
Authors
Aki Ashitani
Toshinori Ueno
Ayumu Nakashima
Shigehiro Doi
Kiminori Yamane
Takao Masaki
Publication date
01-08-2018
Publisher
Springer Singapore
Published in
Clinical and Experimental Nephrology / Issue 4/2018
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-017-1522-6

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