Table 3.
Longitudinal associations of serum and urine albumin concentrations with rapid kidney function decline
| Outcome = rapid eGFR decline >30% (451/2598 = 17%) | ||||||
|---|---|---|---|---|---|---|
| n | No. of patients rapid decline | Unadjusted | Model 1a | Model 2b | Model 3c | |
| OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |||
| Serum albumin | ||||||
| per SD decrease = 0.31 | 2598 | 451 | 1.19 (1.09, 1.27)* | 1.20 (1.09, 1.29)* | 1.18 (1.07, 1.27)** | 1.19 (1.09, 1.28)** |
| Quartiles | ||||||
| >4.21 | 510 | 77 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| 4.01–4.20 | 567 | 98 | 1.21 (0.83, 1.73) | 1.21 (0.84, 1.76) | 1.18 (0.81, 1.71) | 1.23 (0.84, 1.80) |
| 3.81–4.00 | 646 | 91 | 0.99 (0.69, 1.43) | 1.01 (0.69, 1.48) | 0.97 (0.66, 1.42) | 1.00 (0.68, 1.46) |
| ≤3.80 | 875 | 185 | 1.58 (1.14, 2.19)** | 1.62 (1.15, 2.28)** | 1.53 (1.08, 2.16)** | 1.59 (1.12, 2.26)** |
| Urine ACR | ||||||
| Urine ACR (per doubling) | 1.20 (1.14, 1.27)* | 1.17 (1.10, 1.24)* | 1.17 (1.10, 1.24)* | 1.18 (1.11, 1.25)* | ||
| Urine ACR (>30 mg/g) | 436 | 119 | 2.27 (1.75, 2.93)* | 2.00 (1.52, 2.65)* | 1.98 (1.50, 2.62)* | 2.06 (1.55, 2.74)* |
| Quartiles | ||||||
| ≤4.00 | 677 | 90 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| 4.01–7.89 | 662 | 112 | 1.27 (0.92, 1.74) | 1.26 (0.91, 1.74) | 1.25 (0.90, 1.72) | 1.31 (0.94, 1.81) |
| 7.90–20.20 | 631 | 100 | 1.12 (0.80, 1.55) | 1.05 (0.75, 1.46) | 1.03 (0.74, 1.45) | 1.09 (0.78, 1.54) |
| >20.20 | 598 | 146 | 2.14 (1.58, 2.90)* | 1.86 (1.34, 2.57)* | 1.81 (1.30, 2.51)* | 1.93 (1.39, 2.69)* |
a
Model 1: demographics and risk factors; model adjusted for age, gender, race, site, DM, SBP, HTN meds, smoking, prevalent cardiovascular disease, high-density lipoprotein, low-density lipoprotein and eGFR.
b
Model 2: inflammation and health; model further adjusted for CRP, IL-6, TNF-α and self-reported health status.
c
Model 3: further adjusted for urine albumin (or serum albumin).
*
P < 0.001.
**
P < 0.05.
CI, confidence interval; OR, odds ratio.