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Proteinuria: natural course, prognostic implications and therapeutic considerations
1Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA University Hospital, Aristotle University, Thessaloniki, Greece. psarafidis11@yahoo.gr
Minerva Medica
|February 27, 2008
Summary
Proteinuria, indicated by elevated urinary albumin excretion (UAE), signifies increased risk for kidney disease and cardiovascular events. Reducing UAE through interventions like blood pressure control can slow disease progression and improve outcomes.
Area of Science:
- Nephrology
- Cardiology
- Clinical Medicine
Background:
- Normally functioning kidneys excrete minimal protein daily.
- Urinary albumin excretion (UAE) above 30 mg/day is abnormal, with microalbuminuria (30-300 mg/day) and macroalbuminuria (>300 mg/day) indicating increasing severity.
- Proteinuria prevalence is low in the general population but significantly higher in patients with diabetes or hypertension.
Purpose of the Study:
- To review the prevalence, natural history, and prognostic implications of proteinuria for renal and cardiovascular endpoints.
- To discuss therapeutic strategies for reducing proteinuria's impact, emphasizing blood pressure control.
- To highlight proteinuria as a risk factor for cardiovascular disease and a marker of nephropathy progression.
Main Methods:
- Review of population studies and post hoc analyses of outcome trials.
- Analysis of data on the association between UAE levels and renal/cardiovascular risks.
- Discussion of therapeutic interventions targeting UAE reduction.
Main Results:
- A continuous association exists between UAE levels and the risk of cardiovascular events, cardiovascular mortality, and overall mortality.
- Proteinuria is a marker of nephropathy and predicts a faster decline in renal function.
- Interventions reducing UAE are linked to slower renal function decline and reduced cardiovascular event risk.
Conclusions:
- Microalbuminuria and proteinuria are established risk factors for cardiovascular disease.
- Proteinuria is a key indicator of kidney disease progression and associated cardiovascular risks.
- Therapeutic strategies aimed at reducing UAE, particularly blood pressure control, are crucial for managing kidney and cardiovascular disease.
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