ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2024
Cardiovascular and Kidney Outcomes of Non-Diabetic CKD by Albuminuria Severity: Findings From the CRIC Study.
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cardiorenal protective effects of glucagon-like peptide-1 receptor agonists in chronic kidney disease: a systematic review and meta-analysis.Renal failure · 2026Pooled it
- Reduction in Albuminuria with Dapagliflozin Exhibits Substantial Interindividual Variability: A Real-World Study Utilizing a Big Data Approach.Balkan medical journal · 2026Observational
- Ethnic Disparities in CKD Progression: A Comparative Study of CRIC and KNOW-CKD Cohorts.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Risk Stratification for Diabetic Kidney Disease Progression in Predicting All-Cause and Cardiovascular Mortality in Type 2 Diabetes: A National Cohort Study From NHANES 1999-2018.Journal of diabetes research · 2026Article
- Ten Hot Topics in Cardiovascular Risk Management for Chronic Kidney Disease.Cardiorenal medicine · 2026Review
- Integrating UHPLC-QE-MS and Bioinformatics with Experimental Validation Reveals MAPK/FOS-Mediated Podocyte Apoptosis as the Key Mechanism ofPharmaceuticals (Basel, Switzerland) · 2025Article
- Blood Pressure Management Strategies and Podocyte Health.American journal of hypertension · 2025Review
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Authors and funding
6 authors.
Funding
Abstract
RATIONALE &
objectiveThe clinical trajectory of normoalbuminuric chronic kidney disease (CKD), particularly in the absence of diabetes, has not yet been well-studied. This study evaluated the association of kidney and cardiovascular outcomes with levels of albuminuria in a cohort of patients with nondiabetic CKD. STUDY
designProspective cohort study. SETTING &
participants1,463 adults with nondiabetic CKD without known glomerulonephritis and diagnosed with hypertensive nephrosclerosis or unknown cause of CKD participating in the Chronic Renal Insufficiency Cohort (CRIC) Study. EXPOSURE: Albuminuria stage at study entry. OUTCOME: Primary outcome: Composite kidney (halving of estimated glomerular filtration rate [eGFR], kidney transplantation, or dialysis), Secondary outcomes: (1) eGFR slope, (2) composite cardiovascular disease events (hospitalization for heart failure, myocardial infarction, stroke, or all-cause death), (3) all-cause death. ANALYTICAL APPROACH: Linear mixed effects and Cox proportional hazards regression analyses.
resultsLower levels of albuminuria were associated with female sex and older age. For the primary outcome, compared with normoalbuminuria, those with moderate and severe albuminuria had higher rates of kidney outcomes (adjusted hazard ratio [AHR], 3.3 [95% CI, 2.4-4.6], and AHR, 8.6 [95% CI, 6.0-12.0], respectively) and cardiovascular outcomes (AHR, 1.5 [95% CI, 1.2-1.9], and AHR, 1.5 [95% CI, 1.1-2.0], respectively). Those with normoalbuminuria (<30μg/mg; n=863) had a slower decline in eGFR (-0.46mL/min/1.73m LIMITATIONS: Self-report of CKD etiology without confirmatory kidney biopsies; residual confounding.
conclusionsParticipants with normoalbuminuric nondiabetic CKD experienced substantially slower CKD progression but only modestly lower cardiovascular risk than those with high levels of albuminuria. These findings inform the design of future studies investigating interventions among individuals with lower levels of albuminuria. PLAIN-LANGUAGE SUMMARY: Diabetes and hypertension are the leading causes of chronic kidney disease (CKD). Urine albumin levels are associated with cardiovascular and kidney disease outcomes among individuals with CKD. However, previous studies of long-term clinical outcomes in CKD largely included patients with diabetes. As well, few studies have evaluated long-term outcomes across different levels of urine albumin among people without diabetes. In this study, we found individuals with nondiabetic CKD and low urine albumin had much slower decline of kidney function but only a modestly lower risk of a cardiovascular events compared with those with high levels of urine albumin. Individuals with low urine albumin were much more likely to have a cardiovascular event than progression of their kidney disease. These findings inform the design of future studies investigating treatments among individuals with lower levels of albuminuria.
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