ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2008
Predictive power of sequential measures of albuminuria for progression to ESRD or death in Pima Indians with type 2 diabetes.
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 5 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 5 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Pooled it
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- Lower estimated GFR and higher albuminuria are associated with adverse kidney outcomes. A collaborative meta-analysis of general and high-risk population cohorts.Kidney international · 2011Pooled it
- Moderate agreement between the spot albumin‒Creatinine ratio (ACR) and urine albumin (UA) among virally suppressed adults living with HIV in botswana: a cross sectional study.AIDS research and therapy · 2025Article
- High prevalence of albuminuria among adult males living with HIV in Botswana.Scientific reports · 2024Observational
- Risk factors associated with albuminuria in Rwanda: results from a STEPS survey.BMC nephrology · 2021Article
- Incidence and Predictors of Chronic Kidney Disease among Diabetes Mellitus Patients: A Retrospective Follow-Up Study at a Tertiary Health-Care Setting of Ethiopia.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Article
- Machine learning, the kidney, and genotype-phenotype analysis.Kidney international · 2020Review
- Observation period for changes in proteinuria and risk prediction of end-stage renal disease in general population.Nephrology (Carlton, Vic.) · 2018Article
- Segmental Sclerosis and Extracapillary Hypercellularity Predict Diabetic ESRD.Journal of the American Society of Nephrology : JASN · 2018Article
- A molecular morphometric approach to diabetic kidney disease can link structure to function and outcome.Kidney international · 2018Article
- Evaluating biomarkers for prognostic enrichment of clinical trials.Clinical trials (London, England) · 2017Article
- Estimation of chronic kidney disease incidence from prevalence and mortality data in American Indians with type 2 diabetes.PloS one · 2017Article
- Association of urinary KIM-1, L-FABP, NAG and NGAL with incident end-stage renal disease and mortality in American Indians with type 2 diabetes mellitus.Diabetologia · 2015Article
- Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar.Kidney international · 2014Article
- The predictive value of albuminuria for renal and nonrenal natural deaths over 14 years follow-up in a remote aboriginal community.Clinical kidney journal · 2012Article
- Early renal function decline in type 2 diabetes.Clinical journal of the American Society of Nephrology : CJASN · 2012Article
- Albuminuria and estimated glomerular filtration rate as predictors of diabetic end-stage renal disease and death.Clinical journal of the American Society of Nephrology : CJASN · 2011Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundTo determine whether historic albuminuria measurements provide additional predictive value for diabetic end-stage renal disease (ESRD) and natural mortality over the most recent measurement, ie, whether "regression" from high albuminuria has a different prognosis than stability at the lower level. STUDY
designObservational longitudinal study. SETTING &
participantsPima Indians 15 years or older with type 2 diabetes and at least 2 consecutive measurements of urinary albumin-creatinine ratio (ACR) within 6 years. PREDICTORS: Sequential measurements of urinary ACR. OUTCOMES & MEASUREMENTS: Proportional hazards analyses were used to estimate the risk of ESRD and natural death associated with the first and second ACR measurement. The ability of these highly correlated variables to predict outcome was compared with receiver operating characteristic curves calculated by means of the generalized c statistic.
resultsIn 983 subjects, 136 developed ESRD and 180 died of natural causes during a maximum follow-up of 12.6 years. Each doubling in the second ACR was associated with a 1.71-fold greater incidence of ESRD (95% confidence interval, 1.54 to 1.89) and 1.16-fold greater natural mortality (95% confidence interval, 1.07 to 1.27) adjusted for age, sex, diabetes duration, and antihypertensive medication. The addition of the first ACR measurement to the model did not add to the predictive value for ESRD or mortality. In pairwise comparisons of c statistics, the second ACR was a significantly better predictor of ESRD than the first ACR. LIMITATIONS: The predictive value of ACR measurements is decreased to the extent that its precision is based on a single measure.
conclusionThe predictive power of the latest ACR for ESRD and natural mortality in patients with diabetes is not enhanced by knowledge of the preceding ACR. Therefore, ACR changes over time, ie, regression or progression, add minimal predictive value beyond the latest measurement in the series.
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