Evidence map›Paper›PMID 39738846›Full record

ArticleClinical rheumatology2025

Urinary albumin-to-creatinine ratio for predicting risk of all-cause mortality and specific-cause mortality in patients with rheumatoid arthritis: evidence from NHANES 1999-2018.

Mengshi Tang, Leilei Du, Jia Peng

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Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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3 · Its place in the literature

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4 citing papers in PubMed.

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5 · Who and what money

Authors and funding

3 authors.

Mengshi TangDepartment of Rheumatology and Immunology, the Second Xiangya Hospital, Central South University, No. 139, Renmin Middle Road, Changsha, 410011, Hunan, China.
Leilei DuLaboratory of Cardiovascular Science, Beijing Clinical Research Institute, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, China. dllwmu2020@163.com.
Jia PengDepartment of Cardiovascular Medicine, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Kaifu District, No. 87 Xiangya Road, Changsha, 410008, Hunan, China. 22022183@csu.edu.cn.ORCID http://orcid.org/0000-0002-7065-7142

Funding

National Natural Science Foundation of China 82300677Natural Science Foundation of Hunan Province 2023JJ40978
6 · The paper itself

Abstract

objectiveTo explore the relationship between urinary albumin-to-creatinine ratio (uACR) and all-cause/specific-cause mortality among patients with rheumatoid arthritis (RA).

methodsThis study included 1354 RA patients in the National Health and Nutritional Examination Surveys (NHANESs) during 1999-2018. The mortality status was assessed by linkage to death certificate data reported in the National Death Index (NDI) until December 31, 2019. Cox proportional hazards models and Kaplan-Meier (K-M) analysis were used to elucidate the relationship between uACR and all-cause/specific-cause mortality. Restricted cubic spline (RCS) was used to visualize the association of uACR with all-cause mortality risk. Stratified analyses were employed to identify patients with higher mortality risk.

resultsOver a median of 115 months of follow-up, 298 deaths occurred. Cox proportional hazards models indicated that RA patients with higher uACR had an increased risk of all-cause mortality, but not cardiovascular disease, kidney disease, and cancer mortality. K-M survival curves showed a significant difference (log-rank, p < 0.001) in all-cause mortality among uACR tertiles. RCS analysis revealed an L-shaped association between uACR and all-cause mortality, and patients with uACR above the threshold points (5.96 mg/g) had a 13.2% increased risk of all-cause mortality (HRs 1.132; 95% CI 1.011, 1.267) for each ln unit increase in uACR. The stratified analysis revealed consistent patterns for correlations between uACR and all-cause mortality.

conclusionsHigh uACR, even in the normal range, was associated with an increased risk of all-cause mortality (not specific-cause mortality) in individuals with RA. Identifying high-risk populations using uACR assessment may contribute to target risk interventions among RA patients in the future. Key points • uACR, even within the normal range, significantly increased the hazard for all-cause mortality among RA patients. • uACR has good performance in identifying populations with different mortality risk levels in RA patients. • uACR, independent of varied well-recognized cardiovascular risk factors, is a predictor of mortality in RA patients.

Indexed as

AlbuminuriaArthritis, RheumatoidCreatinineAdultAgedCause of DeathFemaleHumansKaplan-Meier EstimateMaleMiddle AgedNutrition SurveysProportional Hazards ModelsRisk FactorsUnited StatesCreatinineMortalityRheumatoid arthritisUrinary albumin-to-creatinine ratio

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PMID39738846

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.