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CKD Progression Risk Up With Increasing Albuminuria in Normal Range

Risk for chronic kidney disease progression increases with increasing urine albumin-creatinine ratio levels within normal range

By Elana Gotkine HealthDay Reporter

MONDAY, April 1, 2024 (HealthDay News) — For people with chronic kidney disease (CKD) and normoalbuminuria, the risk for CKD progression increases with higher levels of albuminuria, according to a study published online April 2 in the Annals of Internal Medicine.

Ashish Verma, M.B., B.S., from the Boston University Chobanian & Avedisian School of Medicine, and colleagues estimated the increase in the cumulative incidence of CKD progression with higher baseline levels of albuminuria among persons with CKD who had normoalbuminuria (<30 mg/g) in a multicenter prospective study. Data were included for 1,629 participants meeting criteria from the Chronic Renal Insufficiency Cohort study with CKD and a urine albumin-creatinine ratio (UACR) <30 mg/g.

The researchers found that 182 of the participants experienced CKD progression during a median follow-up of 9.8 years. For UACR levels of 0 to <5, 5 to <15, and ≥15 mg/g, the 10-year adjusted cumulative incidences of CKD progression were 8.7, 11.5, and 19.5 percent, respectively. The absolute risk differences were 7.9 and 10.7 percent comparing persons with UACR ≥15 mg/g to those with UACR of 5 to <15 and 0 to <5 mg/g, respectively. There was a linear increase observed in 10-year adjusted cumulative incidence based on baseline UACR levels.

“These findings underscore the need for future studies to determine the optimal threshold for initiating treatment with antiproteinuric agents and whether the further reduction in albuminuria may improve adverse clinical outcomes in persons with CKD who have normoalbuminuria,” the authors write.

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