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Racial differences in albuminuria, kidney function, and risk of stroke.
Neurology. 2012 Oct 16; 79(16):1686-92.Neur

Abstract

BACKGROUND

The objective of this study was to examine the joint associations of estimated glomerular filtration rate (eGFR) and urinary albumin excretion with incident stroke in a large national cohort study.

METHODS

Associations of urinary albumin to creatinine ratio (ACR) and eGFR with incident stroke were examined in 25,310 participants of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a prospective study of black and white US adults ≥45 years of age.

RESULTS

A total of 548 incident strokes were observed over a median of 4.7 years of follow-up. Higher ACR values were associated with lower stroke-free survival in both black and white participants. Among black participants, as compared to an ACR <10 mg/g, the hazard ratios of stroke associated with an ACR of 10-29.99, 30-300, and >300 mg/g were 1.41 (95% confidence interval [CI] 1.01-1.98), 2.10 (95% CI 1.48-2.99), and 2.70 (95% CI 1.58-4.61), respectively, in analyses adjusted for traditional stroke risk factors and eGFR. In contrast, the hazard ratios among white subjects were only modestly elevated and not statistically significant after adjustment for established stroke risk factors. eGFR <60 mL/min/1.73 m(2) was not associated with incident stroke in black or white participants after adjustment for established stroke risk factors.

CONCLUSIONS

Higher ACR was independently associated with higher risk of stroke in black but not white participants from a national cohort. Elucidating the reasons for these findings may uncover novel mechanisms for persistent racial disparities in stroke.

Authors+Show Affiliations

Departments of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. ogutierr@uab.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22993285

Citation

Gutiérrez, Orlando M., et al. "Racial Differences in Albuminuria, Kidney Function, and Risk of Stroke." Neurology, vol. 79, no. 16, 2012, pp. 1686-92.
Gutiérrez OM, Judd SE, Muntner P, et al. Racial differences in albuminuria, kidney function, and risk of stroke. Neurology. 2012;79(16):1686-92.
Gutiérrez, O. M., Judd, S. E., Muntner, P., Rizk, D. V., McClellan, W. M., Safford, M. M., Cushman, M., Kissela, B. M., Howard, V. J., & Warnock, D. G. (2012). Racial differences in albuminuria, kidney function, and risk of stroke. Neurology, 79(16), 1686-92. https://doi.org/10.1212/WNL.0b013e31826e9af8
Gutiérrez OM, et al. Racial Differences in Albuminuria, Kidney Function, and Risk of Stroke. Neurology. 2012 Oct 16;79(16):1686-92. PubMed PMID: 22993285.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial differences in albuminuria, kidney function, and risk of stroke. AU - Gutiérrez,Orlando M, AU - Judd,Suzanne E, AU - Muntner,Paul, AU - Rizk,Dana V, AU - McClellan,William M, AU - Safford,Monika M, AU - Cushman,Mary, AU - Kissela,Brett M, AU - Howard,Virginia J, AU - Warnock,David G, Y1 - 2012/09/19/ PY - 2012/9/21/entrez PY - 2012/9/21/pubmed PY - 2012/12/27/medline SP - 1686 EP - 92 JF - Neurology JO - Neurology VL - 79 IS - 16 N2 - BACKGROUND: The objective of this study was to examine the joint associations of estimated glomerular filtration rate (eGFR) and urinary albumin excretion with incident stroke in a large national cohort study. METHODS: Associations of urinary albumin to creatinine ratio (ACR) and eGFR with incident stroke were examined in 25,310 participants of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a prospective study of black and white US adults ≥45 years of age. RESULTS: A total of 548 incident strokes were observed over a median of 4.7 years of follow-up. Higher ACR values were associated with lower stroke-free survival in both black and white participants. Among black participants, as compared to an ACR <10 mg/g, the hazard ratios of stroke associated with an ACR of 10-29.99, 30-300, and >300 mg/g were 1.41 (95% confidence interval [CI] 1.01-1.98), 2.10 (95% CI 1.48-2.99), and 2.70 (95% CI 1.58-4.61), respectively, in analyses adjusted for traditional stroke risk factors and eGFR. In contrast, the hazard ratios among white subjects were only modestly elevated and not statistically significant after adjustment for established stroke risk factors. eGFR <60 mL/min/1.73 m(2) was not associated with incident stroke in black or white participants after adjustment for established stroke risk factors. CONCLUSIONS: Higher ACR was independently associated with higher risk of stroke in black but not white participants from a national cohort. Elucidating the reasons for these findings may uncover novel mechanisms for persistent racial disparities in stroke. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/22993285/Racial_differences_in_albuminuria_kidney_function_and_risk_of_stroke_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=22993285 DB - PRIME DP - Unbound Medicine ER -