Baseline Glycated Albumin Predicts the Renal Dysfunction in a Five-Year Prospective Population-Based Study

Glycated albumin (GA) was reported to be associated with renal dysfunction in non-diabetic CKD population. This study assessed the correlation of GA and renal dysfunction and explored risk factors affecting renal progression in a general population-based study through a five-year follow-up.

Individuals who underwent a physical examination between September 2010 and September 2015 were enrolled. Multivariate linear regression was performed to assess the relationship between GA and eGFR change rate. The relationship between GA and renal progression was analyzed by multivariate logistic regression among 1,501 participants. Other risk factors were also explored and their predictive value was evaluated by ROC analysis, external validation was carried out in another 603 participants from the general population.

The frequencies of subjects with renal progression increased obviously with the increment of baseline and mean GA according to quartile stratification (p for trend < 0.001). Baseline GA, age, and uric acid (p < 0.05) were identified as risk factors for renal dysfunction with a 30% or more decrease of eGFR. For every 1% increase of GA, the risk of deterioration of renal function increased to 1.585 in the population (95% CI, 1.299 - 1.935, p < 0.001). The predictive value of the model-building equation was confirmed by ROC analysis (AUC = 0.82, 95% CI: 0.773 - 0.832, p < 0.001) and in the validation group, predictive sensitivity and specificity were 85.7% and 73.5%.

Baseline GA is independently associated with renal dysfunction. Uric acid and age are also considered risk factors. GA combining with age, serum creatinine and uric acid can serve as predictive indicators for the progression of renal dysfunction.