The following is a summary of “Associations Between Albuminuria and Mortality Among US Adults by Demographic and Comorbidity Factors,” published in the October 2023 issue of Cardiology by Drexler et al.

In this study, encompassing 49,640 participants from the National Health and Nutrition Examination Survey spanning 1999 to 2018, researchers aimed to ascertain the distinct correlation between albuminuria and mortality concerning demographic and comorbidity factors. All-cause mortality data until 2019 was collected from the National Death Index. Utilizing multivariable-adjusted Poisson regression models, the study group explored the association between urine albumin-to-creatinine ratio (ACR) levels and mortality, adjusting for various factors, including demographics, socioeconomic status, behaviors, and clinical conditions. 

With a mean age of 46 years in the cohort, where 51.3% were female and 30.3% exhibited an ACR ≥10 mg/g, the investigators observed 6,813 deaths over a median follow-up of 9.5 years. ACR levels of ≥300 were linked with a 132% higher risk of mortality overall (95% CI, 2.01–2.68). This association was consistent among men (124%, 95% CI, 1.84–2.73), women (158%, 95% CI, 2.14–3.11), non-Hispanic White adults (130%, 95% CI: 1.89–2.79), non-Hispanic Black adults (135%, 95% CI, 1.82–3.04), and Hispanic adults (114%, 95% CI, 1.55–2.94) when compared to those with an ACR <10. 

Additionally, the increased risk of mortality associated with an ACR ≥300 varied across individuals without hypertension or hypercholesterolemia (148%, 95% CI, 1.69–3.64), those with hypertension alone (128%, 95% CI, 1.86–2.79), and those with both hypertension and hypercholesterolemia (166%, 95% CI, 2.18–3.26) compared to those with ACR <10. These findings emphasize a robust connection between albuminuria and mortality risk, evident even at mildly elevated levels across diverse demographic groups and various comorbid conditions.

Source: ahajournals.org/doi/10.1161/JAHA.123.030773