American Journal of Kidney Diseases
Volume 53, Issue 3 , Pages 417-425 , March 2009

Proteinuria and Stroke: A Meta-analysis of Cohort Studies

  • Toshiharu Ninomiya, MD, PhD

      Affiliations

    • The George Institute for International Health, The University of Sydney, Sydney, Australia
    • ,
  • Vlado Perkovic, MD, PhD

      Affiliations

    • The George Institute for International Health, The University of Sydney, Sydney, Australia
    • Corresponding Author InformationAddress correspondence to Vlado Perkovic, MD, PhD, The George Institute for International Health, The University of Sydney, Level 10, King George V Bldg, Royal Prince Alfred Hospital, Camperdown, Sydney NSW 2050, Australia
    • ,
  • Christine Verdon, MSc(A)

      Affiliations

    • School of Public Health, The University of Sydney, Sydney, Australia
    • ,
  • Federica Barzi, PhD

      Affiliations

    • The George Institute for International Health, The University of Sydney, Sydney, Australia
    • ,
  • Alan Cass, MD, PhD

      Affiliations

    • The George Institute for International Health, The University of Sydney, Sydney, Australia
    • ,
  • Martin Gallagher, MD, MPH

      Affiliations

    • The George Institute for International Health, The University of Sydney, Sydney, Australia
    • ,
  • Meg Jardine, MD

      Affiliations

    • The George Institute for International Health, The University of Sydney, Sydney, Australia
    • ,
  • Craig Anderson, MD, PhD

      Affiliations

    • The George Institute for International Health, The University of Sydney, Sydney, Australia
    • ,
  • John Chalmers, MD, PhD

      Affiliations

    • The George Institute for International Health, The University of Sydney, Sydney, Australia
    • ,
  • Jonathan C. Craig, MD, PhD

      Affiliations

    • School of Public Health, The University of Sydney, Sydney, Australia
    • ,
  • Rachel Huxley, DPhil

      Affiliations

    • The George Institute for International Health, The University of Sydney, Sydney, Australia

Received 30 April 2008 ,Accepted 29 August 2008.

References 

  1. WHO in collaboration with the US Centers for Disease Control and Prevention: The Atlas of Heart Disease and Stroke (Global Burden of Stroke). http://www.who.int/cardiovascular_diseases/resources/atlas/en/index.htmlAccessed August 28, 2008
  2. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–2497
  3. Asia Pacific Cohort Studies Collaboration. Joint effects of systolic blood pressure and serum cholesterol on cardiovascular disease in the Asia Pacific region. Circulation. 2005;112:3384–3390
  4. Woodward M, Zhang X, Barzi F, et al. The effects of diabetes on the risks of major cardiovascular diseases and death in the Asia-Pacific region. Diabetes Care. 2003;26:360–366
  5. Valmadrid CT, Klein R, Moss SE, Klein BE. The risk of cardiovascular disease mortality associated with microalbuminuria and gross proteinuria in persons with older-onset diabetes mellitus. Arch Intern Med. 2000;160:1093–1100
  6. Miettinen H, Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Proteinuria predicts stroke and other atherosclerotic vascular disease events in nondiabetic and non-insulin-dependent diabetic subjects. Stroke. 1996;27:2033–2039
  7. Madison JR, Spies C, Schatz IJ, et al. Proteinuria and risk for stroke and coronary heart disease during 27 years of follow-up: the Honolulu Heart Program. Arch Intern Med. 2006;166:884–889
  8. Irie F, Iso H, Sairenchi T, et al. The relationships of proteinuria, serum creatinine, glomerular filtration rate with cardiovascular disease mortality in Japanese general population. Kidney Int. 2006;69:1264–1271
  9. Nakayama T, Date C, Yokoyama T, Yoshiike N, Yamaguchi M, Tanaka H. A 15.5-year follow-up study of stroke in a Japanese provincial city: The Shibata Study. Stroke. 1997;28:45–52
  10. Sasaki A, Horiuchi N, Hasegawa K, Uehara M. Mortality from coronary heart disease and cerebrovascular disease and associated risk factors in diabetic patients in Osaka District, Japan. Diabetes Res Clin Pract. 1995;27:77–83
  11. Wagner DK, Harris T, Madans JH. Proteinuria as a biomarker: Risk of subsequent morbidity and mortality. Environ Res. 1994;66:160–172
  12. Garg AX, Kiberd BA, Clark WF, Haynes RB, Clase CM. Albuminuria and renal insufficiency prevalence guides population screening: Results from the NHANES III. Kidney Int. 2002;61:2165–2167
  13. Atkins RC, Polkinghorne KR, Briganti EM, Shaw JE, Zimmet PZ, Chadban SJ. Prevalence of albuminuria in Australia: The AusDiab Kidney Study. Kidney Int Suppl. 2004;92:S22–S24
  14. Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of Observational Studies in Epidemiology: A proposal for reporting (Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group). JAMA. 2000;283:2008–2012
  15. Sarnak MJ, Levey AS, Schoolwerth AC, et al. Kidney disease as a risk factor for development of cardiovascular disease: A statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation. 2003;108:2154–2169
  16. Fuller JH, Stevens LK, Wang SL. Risk factors for cardiovascular mortality and morbidity: The WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia. 2001;44(suppl 2):S54–S64
  17. Woodward M. Epidemiology: Study Design and Data Analysis. (ed 2). Boca Raton, FL: Chapman & Hall/CRC; 2005;
  18. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: Systematic review and meta-analysis. JAMA. 2007;297:842–857
  19. Yuyun MF, Khaw KT, Luben R, et al. Microalbuminuria and stroke in a British population: The European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) population study. J Intern Med. 2004;255:247–256
  20. Nakano M, Nojiri M, Arai H. Correlation of cerebro-cardiovascular findings to mortality of middle-aged and elderly in a population from a fishing village in Shizuoka Prefecture. Nippon Koshu Eisei Zasshi. 1990;37:21–32
  21. Stehouwer CD, Smulders YM. Microalbuminuria and risk for cardiovascular disease: Analysis of potential mechanisms. J Am Soc Nephrol. 2006;17:2106–2211
  22. Chen J, Muntner P, Hamm LL, et al. The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med. 2004;140:167–174
  23. Pontremoli R, Sofia A, Ravera M, et al. Prevalence and clinical correlates of microalbuminuria in essential hypertension: The MAGIC Study (Microalbuminuria: A Genoa Investigation on Complications). Hypertension. 1997;30:1135–1143
  24. Barzilay JI, Peterson D, Cushman M, et al. The relationship of cardiovascular risk factors to microalbuminuria in older adults with or without diabetes mellitus or hypertension: The Cardiovascular Health Study. Am J Kidney Dis. 2004;44:25–34
  25. Hillege HL, Janssen WM, Bak AA, et al. Microalbuminuria is common, also in a nondiabetic, nonhypertensive population, and an independent indicator of cardiovascular risk factors and cardiovascular morbidity. J Intern Med. 2001;249:519–526
  26. Bigazzi R, Bianchi S, Nenci R, Baldari D, Baldari G, Campese VM. Increased thickness of the carotid artery in patients with essential hypertension and microalbuminuria. J Hum Hypertens. 1995;9:827–833
  27. Dell'Omo G, Penno G, Giorgi D, Di Bello V, Mariani M, Pedrinelli R. Association between high-normal albuminuria and risk factors for cardiovascular and renal disease in essential hypertensive men. Am J Kidney Dis. 2002;40:1–8
  28. Wachtell K, Palmieri V, Olsen MH, et al. Urine albumin/creatinine ratio and echocardiographic left ventricular structure and function in hypertensive patients with electrocardiographic left ventricular hypertrophy: The LIFE Study (Losartan Intervention for Endpoint Reduction). Am Heart J. 2002;143:319–326
  29. Diercks GF, Hillege HL, van Boven AJ, et al. Relation between albumin in the urine and electrocardiographic markers of myocardial ischemia in patients without diabetes mellitus. Am J Cardiol. 2001;88:771–774
  30. Caring for Australians with Renal Impairment (CARI). Urine protein as diagnostic test: Performance characteristics of tests used in the initial evaluation of patients at risk of renal disease. Nephrology. 2004;9(suppl 3):S8–S14
  31. Craig JC, Barratt A, Cumming R, Irwig L, Salkeld G. Feasibility study of the early detection and treatment of renal disease by mass screening. Intern Med J. 2002;32:6–14
  32. Scheid DC, McCarthy LH, Lawler FH, Hamm RM, Reilly KE. Screening for microalbuminuria to prevent nephropathy in patients with diabetes: A systematic review of the evidence. J Fam Pract. 2001;50:661–668
  33. de Zeeuw D, Remuzzi G, Parving HH, et al. Albuminuria, a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy. Circulation. 2004;110:921–927
  34. Ibsen H, Olsen MH, Wachtell K, et al. Reduction in albuminuria translates to reduction in cardiovascular events in hypertensive patients: Losartan Intervention For Endpoint Reduction In Hypertension Study. Hypertension. 2005;45:198–202
  35. Foster MC, Hwang SJ, Larson MG, et al. Cross-classification of microalbuminuria and reduced glomerular filtration rate: Associations between cardiovascular disease risk factors and clinical outcomes. Arch Intern Med. 2007;167:1386–1392
  36. Hallan S, Astor B, Romundstad S, Aasarød K, Kvenild K, Coresh J. Association of kidney function and albuminuria with cardiovascular mortality in older vs younger individuals: The HUNT II Study. Arch Intern Med. 2007;167:2490–2496
  37. Cirillo M, Lanti MP, Menotti A, et al. Definition of kidney dysfunction as a cardiovascular risk factor: Use of urinary albumin excretion and estimated glomerular filtration rate. Arch Intern Med. 2008;168:617–624

 Originally published online as doi:10.1053/j.ajkd.2008.08.032 on December 15, 2008.

PII: S0272-6386(08)01430-3

doi: 10.1053/j.ajkd.2008.08.032

American Journal of Kidney Diseases
Volume 53, Issue 3 , Pages 417-425 , March 2009

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