Estimated GFR, Albuminuria, and Complications of Chronic Kidney Disease
Estimated GFR, Albuminuria, and Complications of Chronic Kidney Disease
复制标题
DOI：
10.1681/asn.2010111181
复制
发表时间：
2011-12-01
影响因子：
13.6
通讯作者：
Muntner, Paul
中科院分区：
文献类型：
--
作者：
Inker, Lesley A.;Coresh, Josef;Muntner, Paul
与估计的肾小球滤过率(EGFR)无关，较高的蛋白尿水平与不良结局的风险增加相关，但蛋白尿是否也与慢性肾脏疾病(CKD)的并发并发症相关尚不清楚。在这里，我们评估了1988-1994年和1999-2006年参加NHANES的30,528名成年参与者的白蛋白/肌酐比值与贫血、酸中毒、高磷血症、低白蛋白血症、甲状旁腺功能亢进症和高血压的关系。经过包括EGFR在内的多变量调整后，较高的白蛋白/肌酐比值与贫血、酸中毒、低白蛋白血症、甲状旁腺功能亢进和高血压有关，但与酸中毒和贫血的相关性较弱。此外，白蛋白/肌酐比率与贫血和酸中毒之间的关系在不同的EGFR地层中并不一致。较高的白蛋白/肌酐比率水平与高磷血症无关。较低的EGFR与较高的所有并发症的患病率相关，并且这些关联比观察到的白蛋白/肌酐比率更强；然而，在多变量调整后，EGFR与低蛋白血症和高血压的关联均为NS。综上所述，蛋白尿和EGFR与CKD的并发症有不同的相关性。
Higher levels of albuminuria associate with increased risk for adverse outcomes independent of estimated GFR (eGFR), but whether albuminuria also associates with concurrent complications specific to chronic kidney disease (CKD) is unknown. Here, we assessed the association of spot albumin-to-creatinine ratio with anemia, acidosis, hyperphosphatemia, hypoalbuminemia, hyperparathyroidisnn, and hypertension among 30,528 adult participants in NHANES 1988-1994 and 1999-2006. After multivariable adjustment including eGFR, higher albumin-to-creatinine ratios associated with anemia, acidosis, hypoalbuminemia, hyperparathyroidism, and hypertension but only weakly associated with acidosis and anemia. Furthermore, the associations between albumin-to-creatinine ratio and both anemia and acidosis were not consistent across eGFR strata. Higher albumin-to-creatinine ratio levels did not associate with hyperphosphatemia. Lower eGFR associated with higher prevalence ratios for all complications, and these associations were stronger than those observed for the albumin-to-creatinine ratio; after multivariable adjustment, however, the associations between eGFR and both hypoalbuminemia and hypertension were NS. In conclusion, albuminuria and eGFR differentially associate with complications of CKD.