Table 2.
Association between proteinuria, kidney dysfunction, and clinical outcomes
|
Hazard ratio
|
|||||
|---|---|---|---|---|---|
|
Adjusted for age, ethnic origin, and sex
|
Fully adjusted*
|
||||
| Outcome | Unadjusted event rate (%) | Ratio (95% CI) | P value | Ratio (95% CI) | P value |
| All cause mortality | |||||
| No proteinuria: | |||||
| GFR ≥60 | 201/2839 (7.1) | 1.0 | 1.0 | ||
| GFR <60 | 74/707 (10.5) | 1.20 (0.91 to 1.58) | 0.203 | 1.41 (1.12 to 1.79) | 0.004 |
| Proteinuria: | |||||
| GFR ≥60 | 49/379 (12.9) | 1.61 (1.17 to 2.20) | 0.003 | 1.69 (1.32 to 2.16) | <0.001 |
| GFR <60 | 47/173 (27.2) | 3.31 (2.39 to 4.59) | <0.001 | 2.39 (1.72 to 3.30) | <0.001 |
| Coronary death or non-fatal myocardial infarction | |||||
| No proteinuria: | |||||
| GFR ≥60 | 293/2839 (10.3) | 1.0 | 1.0 | ||
| GFR <60 | 87/707 (12.3) | 1.19 (0.93 to 1.53) | 0.173 | 1.28 (1.03 to 1.60) | 0.03 |
| Proteinuria: | |||||
| GFR ≥60 | 60/379 (15.8) | 1.47 (1.11 to 1.95) | 0.007 | 1.43 (1.14 to 1.81) | 0.003 |
| GFR <60 | 38/173 (22.0) | 2.31 (1.63 to 3.26) | <0.001 | 1.84 (1.35 to 2.50) | <0.001 |
| New symptomatic heart failure | |||||
| No proteinuria: | |||||
| GFR ≥60 | 150/2839 (5.3) | 1.0 | 1.0 | ||
| GFR <60 | 65/707 (9.2) | 1.28 (0.94 to 1.73) | 0.115 | 1.31 (1.01 to 1.71) | 0.04 |
| Proteinuria: | |||||
| GFR ≥60 | 50/379 (13.2) | 2.13 (1.54 to 2.95) | <0.001 | 1.83 (1.40 to 2.40) | <0.001 |
| GFR <60 | 36/173 (20.8) | 3.30 (2.28 to 4.79) | <0.001 | 2.41 (1.68 to 3.45) | <0.001 |
| Stroke | |||||
| No proteinuria: | |||||
| GFR ≥60 | 71/2839 (2.5) | 1.0 | 1.0 | ||
| GFR <60 | 28/707 (4.0) | 1.07 (0.68 to 1.69) | 0.761 | 1.25 (0.84 to 1.84) | 0.27 |
| Proteinuria: | |||||
| GFR ≥60 | 16/379 (4.2) | 1.41 (0.82 to 2.45) | 0.216 | 1.33 (0.87 to 2.03) | 0.19 |
| GFR <60 | 15/173 (8.7) | 2.61 (1.48 to 4.61) | 0.001 | 1.66 (0.95 to 2.90) | 0.08 |
Proteinuria was defined by ≥1+ proteinuria on routine dipstick urinalysis; GFR ≥60/<60 means estimated glomerular filtration rate ≥60/<60 ml/min/1.73m2. The number of participants in each category was 2839 (no proteinuria, GFR ≥60), 707 (no proteinuria, GFR <60), 379 (proteinuria, GFR ≥60), and 173 (proteinuria, GFR <60).
Factors adjusted for: age, sex, ethnic origin, smoking status, diabetic status, waist to hip circumference ratio, fasting glucose, haemoglobin, serum albumin, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure, country of treatment (US v Canada), left ventricular ejection fraction, and use of drugs (β adrenergic blockers, angiotensin converting enzyme inhibitors, aspirin, or pravastatin).