Trial reportJournal of the American Society of Nephrology : JASN2012
Measurable urinary albumin predicts cardiovascular risk among normoalbuminuric patients with type 2 diabetes.
Trial report in Journal of the American Society of Nephrology : JASN, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 94 citations in OpenAlex.
- Cardiovascular and renal outcomes by baseline albuminuria status and renal function: Results from the LEADER randomized trial.Diabetes, obesity & metabolism · 2020Trial
- Cardiovascular Outcomes According to Urinary Albumin and Kidney Disease in Patients With Type 2 Diabetes at High Cardiovascular Risk: Observations From the SAVOR-TIMI 53 Trial.JAMA cardiology · 2018Trial
- Sex Differences in the Cardiovascular Significance of Albuminuria in Type 2 Diabetes: A Narrative Review.Journal of clinical medicine · 2026Review
- Sodium-Glucose Cotransporter-2 Inhibitors and Cardiorenal Events in Nonalbuminuric Kidney Disease.Kidney international reports · 2026Article
- Sex differences in the prognostic value of urinary albumin-to-creatinine ratio for coronary artery disease and cardiovascular events in people with type 2 diabetes and normoalbuminuria.Cardiovascular diabetology · 2025Article
- The relationship between low levels of albuminuria and mortality among adults without major cardiovascular risk factors.European journal of preventive cardiology · 2024Article
- Urinary extracellular vesicles as a monitoring tool for renal damage in patients not meeting criteria for chronic kidney disease.Journal of extracellular biology · 2024Article
- The Urinary Glycopeptide Profile Differentiates Early Cardiorenal Risk in Subjects Not Meeting Criteria for Chronic Kidney Disease.International journal of molecular sciences · 2024Article
- Precision prognostics for cardiovascular disease in Type 2 diabetes: a systematic review and meta-analysis.Communications medicine · 2024Article
- The relationship between low levels of albuminuria and cardiovascular mortality among apparently healthy adults.medRxiv : the preprint server for health sciences · 2023Article
- Association of high-normal albuminuria and vascular aging: Hanzhong adolescent hypertension study.Journal of clinical hypertension (Greenwich, Conn.) · 2023Article
- Podocyturia: an earlier biomarker of cardiovascular outcomes.Scientific reports · 2022Article
- Evidence of chronic kidney injury in patients not meeting KDIGO criteria for chronic kidney disease.Clinical kidney journal · 2022Article
- The Lower Limit of Reference of Urinary Albumin/Creatinine Ratio and the Risk of Chronic Kidney Disease Progression in Patients With Type 2 Diabetes Mellitus.Frontiers in endocrinology · 2022Article
- The Role of Vascular Lesions in Diabetes Across a Spectrum of Clinical Kidney Disease.Kidney international reports · 2021Article
- TCA Cycle and Fatty Acids Oxidation Reflect Early Cardiorenal Damage in Normoalbuminuric Subjects with Controlled Hypertension.Antioxidants (Basel, Switzerland) · 2021Article
- Effect of a gluten-free diet on albuminuria in children with newly diagnosed celiac disease.Glomerular diseases · 2021Article
- Impact of a Complement Factor H Gene Variant on Renal Dysfunction, Cardiovascular Events, and Response to ACE Inhibitor Therapy in Type 2 Diabetes.Frontiers in genetics · 2019Article
- Chronic hyperkalemia in non-dialysis CKD: controversial issues in nephrology practice.Journal of nephrology · 2018Review
- The establishment and validation of novel therapeutic targets to retard progression of chronic kidney disease.Kidney international supplements · 2017Review
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
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 <1 μg/min (HR, 1.04; 95% CI, 1.02-1.07). This relationship was similar in the subgroup originally randomly assigned to non-ACEI therapy. Among those originally receiving ACEI therapy, however, the event rate was uniformly low and was not significantly associated with albuminuria. Taken together, among normoalbuminuric patients with type 2 diabetes, any degree of measurable albuminuria bears significant cardiovascular risk. The association with risk is continuous but is lost with early ACEI therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.