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Low-grade albuminuria and cardiovascular risk

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Abstract

Microalbuminuria (MA), conventionally defined as a urinary albumin excretion (UAE) of 30–300 mg/day, is recognised as a marker of endothelial dysfunction. Furthermore, it represents an established risk factor for cardiovascular morbidity and mortality and for end-stage renal disease in individuals with an adverse cardiovascular risk profile. It is common in the general population, particularly in patients with diabetes mellitus or arterial hypertension. There is growing evidence from prospective observational trials that UAE levels well below the current MA threshold (“lowgrade MA”) are also associated with an increased risk of incident cardiovascular disease and allcause mortality. Even in apparently healthy individuals (without diabetes or hypertension), such an association has been shown. As albuminuria screening assays that are reliable even in the lower ranges are commercially available, there may be an important clinical role for MA in disease screening, comparable to the role of blood pressure and lipid screening. MA is modifiable, and the inhibition of the renin-angiotensin system by ACE inhibitors and AT1 receptor antagonists has been shown to result in a lower incidence of cardiovascular events.

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Authors and Affiliations

  1. Medizinische Klinik 4, Nephrologie und Hypertensiologie, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Germany

    Roland E. Schmieder

  2. Medizinische Klinik, St. Josefs Hospital, Cloppenburg

    Joachim Schrader

  3. Carité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin

    Walter Zidek

  4. Medizinische Klinik Lippe-Detmold, Detmold

    Ulrich Tebbe

  5. Sanofi-Aventis Deutschland GmbH, Medical Affairs CardioVascular/Thrombosis, Berlin

    W. Dieter Paar

  6. Institut für Klinische Pharmakologie, Technische Universität Dresden, Dresden

    Peter Bramlage & D. Pittrow

  7. Universitätsklinikum des Saarlandes, Klinik für Innere Medizin III, Homburg/Saar

    Michael Böhm

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  1. Roland E. Schmieder
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  2. Joachim Schrader
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Correspondence to Roland E. Schmieder.

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Schmieder, R.E., Schrader, J., Zidek, W. et al. Low-grade albuminuria and cardiovascular risk. Clin Res Cardiol 96, 247–257 (2007). https://doi.org/10.1007/s00392-007-0510-3

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