Recent research has linked an early sign of kidney disease to higher risks for hypertension and coronary conditions. A new meta-analysis confirmed “a strong and continuous association between urinary proteinuria and subsequent risk of coronary heart disease (CHD).” The data are so robust that “urinary proteinuria should be incorporated into the assessment of an individual's cardiovascular risk,” Australian researchers urged (PLoS Med. 2008;5:e207).
The investigators analyzed the risk of coronary disease against three factors: proteinuria (total urinary protein excretion >300 mg/day), microalbuminuria (urinary albumin excretion [UAE], 30-300 mg/day), and macroalbuminuria (UAE >300 mg/day).
Proteinuria was associated with about a 50% increase in the likelihood of developing CHD. While subjects with microalbuminuria were also at about 50% greater risk, those with macroalbuminuria were more than twice as likely to develop CHD as those with normal urinary albumin.
Meanwhile, a team of French scientists has tied excessive UAE levels to substantially higher risks of developing diabetes in men. (J Hypertens. 2008;26:2198-2206). “Measuring urinary albumin excretion may provide a simple new test to assess diabetes risk,” they concluded.
The analysis was based on data from an ongoing study of risk factors for insulin resistance syndrome. Among men, that risk rose steadily with UAE, until it more than quadrupled for those with UAE >200 mg/L as compared with those who had UAE <9 mg/L. UAE functioned independently of BMI, activity, diet, smoking, family history, and other established variables.
Curiously, for reasons that were not clear, UAE was not a risk factor for diabetes among women.
The next step, the researchers suggested, is to determine whether lowering UAE can help reduce diabetes risk.