Measurable urinary albumin predicts cardiovascular risk among normoalbuminuric patients with type 2 diabetes

Piero Ruggenenti, Esteban Porrini, Nicola Motterlini, Annalisa Perna, Aneliya Parvanova Ilieva, Ilian Petrov Iliev, Alessandro Roberto Dodesini, Roberto Trevisan, Antonio Bossi, Giuseppe Sampietro, Enrica Capitoni, Flavio Gaspari, Nadia Rubis, Bogdan Ene-Iordache, Giuseppe Remuzzi

Research output: Contribution to journalArticlepeer-review

Abstract

Micro- or macroalbuminuria is associated with increased cardiovascular risk factors among patients with type 2 diabetes, but whether albuminuria within the normal range predicts long-term cardiovascular risk is unknown. We evaluated the relationships between albuminuria and cardiovascular events in 1208 hypertensive, normoalbuminuric patients with type 2 diabetes from the BErgamo NEphrologic Diabetes Complication Trial (BENEDICT), all of whom received angiotensin-converting enzyme inhibitor (ACEI) therapy at the end of the trial and were followed for a median of 9.2 years. The main outcome was time to the first of fatal or nonfatal myocardial infarction; stroke; coronary, carotid, or peripheral artery revascularization; or hospitalization for heart failure. Overall, 189 (15.6%) of the patients experienced a main outcome event (2.14 events/100 patient-years); 24 events were fatal. Albuminuria independently predicted events (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.02-1.08). Second-degree polynomial multivariable analysis showed a continuous nonlinear relationship between albuminuria and events without thresholds. Considering the entire study population, even albuminuria at 1-2 μg/min was significantly associated with increased risk compared with albuminuria

Original languageEnglish
Pages (from-to)1717-1724
Number of pages8
JournalJournal of the American Society of Nephrology
Volume23
Issue number10
DOIs
Publication statusPublished - Sep 28 2012

ASJC Scopus subject areas

  • Nephrology

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