From the Guidelines
Albuminuria is harmful because it indicates kidney damage and can lead to serious health complications, including increased risks of progressive kidney function decline, cardiovascular disease, and premature death. It occurs when the kidneys leak albumin (a protein) into the urine due to damaged filtering mechanisms. This condition serves as an early warning sign of kidney disease and is associated with increased risks of cardiovascular disease and premature death 1. The presence of albumin in urine reflects underlying damage to the glomeruli (kidney filters), which allows proteins that should remain in the bloodstream to escape into the urine.
Some key points to consider about albuminuria include:
- It is a strong predictor of cardiovascular risk, with the greater the level of albuminuria, the greater the risk for a cardiovascular event 1
- It is associated with a failure of nocturnal drops in arterial pressure, insulin resistance, and abnormal vascular responsiveness to various stimuli 1
- The degree of albuminuria is associated with risk of cardiovascular disease, CKD progression, and mortality, regardless of the eGFR level 1
- Regular screening for albuminuria is essential for patients with conditions like diabetes or hypertension, as early detection and treatment with medications such as ACE inhibitors or ARBs can help reduce protein leakage and slow disease progression 1
Overall, the presence of albuminuria is a significant indicator of kidney damage and increased risk of cardiovascular disease, making regular screening and treatment essential for patients with conditions like diabetes or hypertension. The most effective way to manage albuminuria is through early detection and treatment with medications such as ACE inhibitors or ARBs, which can help reduce protein leakage and slow disease progression 1.
From the Research
Why Albuminuria is Considered Bad
- Albuminuria is a key marker of kidney damage and a strong predictor of kidney and cardiovascular outcomes 2, 3, 4, 5, 6.
- It is associated with an increased risk of coronary artery disease, stroke, heart failure, arrhythmias, and microvascular disease 4, 5.
- Elevated urinary albumin excretion indicates kidney damage and systemic vascular disease, including myocardial capillary disease and arterial stiffness 4.
- Albuminuria is also recognized as a biomarker for the risk of cardiovascular disease, and its presence can indicate widespread endothelial dysfunction 5.
Health Implications
- The presence of albuminuria is associated with increased mortality, poor cardiovascular outcomes, and high economic burden 2.
- It is a useful marker for early screening and diagnosis of kidney impairment, especially in people with pre-diabetes or type 2 diabetes 2.
- Albuminuria assessment is now integrated into CKD staging, cardiovascular risk prediction models, and therapy selection 3.
Importance of Screening and Management
- Early screening and diagnosis of kidney function decline in people with type 2 diabetes or pre-diabetes is crucial 2.
- Screening for albuminuria is still low, and health care professionals managing patients with cardiovascular disease should be aware of the benefits of albuminuria surveillance and management 4.
- Future research is needed to determine how broadly and how frequently to screen patients for albuminuria, and whether it is cost-effective to treat low-grade albuminuria 5.