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Cardiovascular implications of proteinuria: an indicator of chronic kidney disease.
Nat Rev Cardiol. 2009 Apr; 6(4):301-11.NR

Abstract

Proteinuria, defined as urine protein excretion greater than 300 mg over 24 h, is a strong and independent predictor of increased risk for all-cause and cardiovascular mortality in patients with and without diabetes. Proteinuria is a sign of persistent dysfunction of the glomerular barrier and often precedes any detectable decline in renal filtration function. Measurement of proteinuria is important in stratifying the risk for cardiovascular disease and chronic kidney disease progression. A variety of basic pathophysiologic mechanisms that can partially explain simultaneous renal and cardiac disease will be discussed in this Review. In addition to being a prognostic marker, proteinuria is being considered as a therapeutic target in cardiovascular medicine. Therapeutic strategies for amelioration of proteinuria by achieving blood pressure targets, glycemic control in diabetes, treatment of hyperlipidemia, and reducing dietary salt and protein intake are also reviewed in this paper. Future clinical studies are needed to assess if proteinuria reduction should be a target of treatment to reduce the burden of end-stage renal disease, cardiovascular disease, and improve survival in this high-risk population.

Authors+Show Affiliations

Department of Internal Medicine, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, MI 48073, USA. varunagrawal1996@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19352334

Citation

Agrawal, Varun, et al. "Cardiovascular Implications of Proteinuria: an Indicator of Chronic Kidney Disease." Nature Reviews. Cardiology, vol. 6, no. 4, 2009, pp. 301-11.
Agrawal V, Marinescu V, Agarwal M, et al. Cardiovascular implications of proteinuria: an indicator of chronic kidney disease. Nat Rev Cardiol. 2009;6(4):301-11.
Agrawal, V., Marinescu, V., Agarwal, M., & McCullough, P. A. (2009). Cardiovascular implications of proteinuria: an indicator of chronic kidney disease. Nature Reviews. Cardiology, 6(4), 301-11. https://doi.org/10.1038/nrcardio.2009.11
Agrawal V, et al. Cardiovascular Implications of Proteinuria: an Indicator of Chronic Kidney Disease. Nat Rev Cardiol. 2009;6(4):301-11. PubMed PMID: 19352334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular implications of proteinuria: an indicator of chronic kidney disease. AU - Agrawal,Varun, AU - Marinescu,Victor, AU - Agarwal,Mohit, AU - McCullough,Peter A, PY - 2009/4/9/entrez PY - 2009/4/9/pubmed PY - 2009/7/7/medline SP - 301 EP - 11 JF - Nature reviews. Cardiology JO - Nat Rev Cardiol VL - 6 IS - 4 N2 - Proteinuria, defined as urine protein excretion greater than 300 mg over 24 h, is a strong and independent predictor of increased risk for all-cause and cardiovascular mortality in patients with and without diabetes. Proteinuria is a sign of persistent dysfunction of the glomerular barrier and often precedes any detectable decline in renal filtration function. Measurement of proteinuria is important in stratifying the risk for cardiovascular disease and chronic kidney disease progression. A variety of basic pathophysiologic mechanisms that can partially explain simultaneous renal and cardiac disease will be discussed in this Review. In addition to being a prognostic marker, proteinuria is being considered as a therapeutic target in cardiovascular medicine. Therapeutic strategies for amelioration of proteinuria by achieving blood pressure targets, glycemic control in diabetes, treatment of hyperlipidemia, and reducing dietary salt and protein intake are also reviewed in this paper. Future clinical studies are needed to assess if proteinuria reduction should be a target of treatment to reduce the burden of end-stage renal disease, cardiovascular disease, and improve survival in this high-risk population. SN - 1759-5010 UR - https://www.unboundmedicine.com/medline/citation/19352334/Cardiovascular_implications_of_proteinuria:_an_indicator_of_chronic_kidney_disease_ L2 - https://doi.org/10.1038/nrcardio.2009.11 DB - PRIME DP - Unbound Medicine ER -