albumin - publications

Predict more albumin - ligand interactions now!


1. Clin J Am Soc Nephrol. 2012 Mar 1. [Epub ahead of print]

Influence of Urine Creatinine on the Relationship between the
Albumin-to-Creatinine Ratio and Cardiovascular Events.

Carter CE, Gansevoort RT, Scheven L, Heerspink HJ, Shlipak MG, de Jong PE, Ix JH.

Department of Medicine and.

Background and objectivesIn the albumin-to-creatinine ratio (spot-ACR), urine
creatinine corrects for tonicity but also reflects muscle mass. Low muscle mass
is associated with cardiovascular disease (CVD). We hypothesized that the
spot-ACR would be higher in women, lower-weight persons, and older individuals,
independent of timed urine albumin excretion (24hr-UAE), and accordingly, that
spot-ACR would be more strongly associated with CVD events than 24hr-UAE in these
subgroups.Design, setting, participants, & methods2627 PREVEND (Prevention of
Renal and Vascular End-stage Disease) participants with 24hr-UAE <30 mg/d were
followed for CVD events for 11 years. Cox regression evaluated associations of
spot-ACR and 24hr-UAE with CVD events by sex, weight, and age.ResultsFemale sex
(26%), lower weight (2% per 5 kg), and older age (4% per 5 years) were associated
with higher spot-ACR independent of 24hr-UAE (P<0.001). Spot urine albumin
concentration (hazard ratio [HR], 1.26 per ln-SD higher) and 1/spot urine
creatinine concentration (HR, 1.16 per ln-SD higher) were associated with CVD
events. Spot-ACR was more strongly associated with CVD events than either
component of the ratio (HR, 1.41 per ln-SD higher). Associations of spot-ACR ≥10
mg/g versus less (HR, 2.33) and 24hr-UAE ≥10 mg/d versus less (HR, 2.09) with CVD
events were similar, and there were no significant differences across subgroups
(P for interactions >0.06).ConclusionsIn community-living individuals with
24hr-UAE <30 mg/d, spot-ACR is higher in women, older persons, and lower-weight
persons, independent of 24hr-UAE. Low spot urine creatinine is associated with
CVD risk, but high urine albumin is a stronger determinant of the association of
spot-ACR with CVD than is low urine creatinine.

PMID: 22383750 [PubMed - as supplied by publisher]