Albuminuria and Estimated Glomerular Filtration Rate Independently Associate with Acute Kidney Injury
Albuminuria and Estimated Glomerular Filtration Rate Independently Associate with Acute Kidney Injury
复制标题
DOI：
10.1681/asn.2010010128
复制
发表时间：
2010-10-01
影响因子：
13.6
通讯作者：
Coresh, Josef
中科院分区：
文献类型：
--
作者：
Grams, Morgan E.;Astor, Brad C.;Coresh, Josef
急性肾损伤（阿基）越来越常见，并且是导致住院患者过度死亡的重要因素。CKD是阿基的既定风险因素;然而，尿白蛋白排泄与阿基的独立分级关联尚不清楚。我们分析了社区动脉粥样硬化风险（ARIC）研究中11，200名参与者的前瞻性队列，以了解基线尿白蛋白/肌酐比值和估计的GFR（eGFR）与阿基住院或死亡之间的关系。阿基事件的发生率为4.0/1000人-年随访。以尿白蛋白/肌酐比值< 10 mg/g的受试者为参照，校正年龄、性别、种族、心血管危险因素和eGFR类别后，阿基的相对危险度为1.9对于尿白蛋白/肌酐比值为11 - 29 mg/g、30 - 299 mg/g和>= 300 mg/g的组，分别为（95% Cl，1.4 - 2.6）、2.2（95% Cl，1.6 - 3.0）和4.8（95% Cl，3.2 - 7.2）。同样，阿基的总体校正相对风险随eGFR降低而增加。在不同年龄、种族和性别的亚组中，这种模式持续存在。总之，白蛋白尿和eGFR与阿基事件有很强的独立相关性。
Acute kidney injury (AKI) is increasingly common and a significant contributor to excess death in hospitalized patients. CKD is an established risk factor for AKI; however, the independent graded association of urine albumin excretion with AKI is unknown. We analyzed a prospective cohort of 11,200 participants in the Atherosclerosis Risk in Communities (ARIC) study for the association between baseline urine albumin-to-creatinine ratio and estimated GFR (eGFR) with hospitalizations or death with AKI. The incidence of AKI events was 4.0 per 1000 person-years of follow-up. Using participants with urine albumin-to-creatinine ratios < 10 mg/g as a reference, the relative hazards of AKI, adjusted for age, gender, race, cardiovascular risk factors, and categories of eGFR were 1.9 (95% Cl, 1.4 to 2.6), 2.2 (95% Cl, 1.6 to 3.0), and 4.8 (95% Cl, 3.2 to 7.2) for urine albumin-to-creatinine ratio groups of 11 to 29 mg/g, 30 to 299 mg/g, and >= 300 mg/g, respectively. Similarly, the overall adjusted relative hazard of AKI increased with decreasing eGFR. Patterns persisted within subgroups of age, race, and gender. In summary, albuminuria and eGFR have strong, independent associations with incident AKI.