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Estimated GFR, albuminuria, and complications of chronic kidney disease

Lesley A Inker1, Josef Coresh, Andrew S Levey

  • 1Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Box 391, Boston, MA 02111, USA. linker@tuftsmedicalcenter.org

Journal of the American Society of Nephrology : JASN
|October 4, 2011
PubMed

Insights

Higher albuminuria levels correlate with chronic kidney disease (CKD) complications like anemia and acidosis, independent of estimated glomerular filtration rate (eGFR). However, albuminuria does not link to hyperphosphatemia, and associations vary with eGFR.

Area of Science:

  • Nephrology
  • Clinical Medicine
  • Biochemistry

Background:

  • Albuminuria is a known risk factor for adverse outcomes in chronic kidney disease (CKD).
  • The association between albuminuria and specific concurrent CKD complications remains unclear.
  • Estimated glomerular filtration rate (eGFR) is a primary marker for CKD severity.

Purpose of the Study:

  • To investigate the association between albuminuria and specific CKD complications.
  • To determine if albuminuria is linked to anemia, acidosis, hyperphosphatemia, hypoalbuminemia, hyperparathyroidism, and hypertension.
  • To compare the associations of albuminuria and eGFR with these complications.

Main Methods:

  • Cross-sectional analysis of 30,528 adult participants from NHANES 1988-1994 and 1999-2006.
  • Assessed the association of spot albumin-to-creatinine ratio with CKD complications.
  • Utilized multivariable regression analysis, adjusting for eGFR and other factors.

Main Results:

  • Higher albumin-to-creatinine ratio associated with anemia, acidosis, hypoalbuminemia, hyperparathyroidism, and hypertension, independent of eGFR.
  • Associations with anemia and acidosis were weak and inconsistent across eGFR strata.
  • No association found between albumin-to-creatinine ratio and hyperphosphatemia.
  • Lower eGFR showed stronger associations with most complications compared to albuminuria.

Conclusions:

  • Albuminuria and eGFR are differentially associated with CKD complications.
  • Albuminuria is linked to several CKD complications, but its association strength varies.
  • Hyperphosphatemia is not associated with higher albuminuria levels.

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