title: Association of C-reactive protein and microalbuminuria (from the National Health and Nutrition Examination Surveys, 1999 to 2004).
abstract: Chronic kidney disease and cardiovascular disease share many risk factors. Injury to the vascular endothelium, measured by elevated levels of serum C-reactive protein (CRP), may play a role in kidney and cardiovascular disease. We therefore examined the association of CRP with microalbuminuria, a marker of early kidney injury. We conducted a cross-sectional analysis of a nationally representative, population-based survey. Weighted multiple logistic regression was used to study the association between CRP and microalbuminuria, adjusting for well-known risk factors. CRP was analyzed by a continuous variable and two categorized variables using quartiles and clinically recommended cutpoints. CRP concentration was positively associated with microalbuminuria. In the multivariate model, a one unit (in milligrams per liter) increase in CRP concentration was associated with a 2% increased odds of microalbuminuria (odds ratio 1.02, 95% confidence interval [CI] 1.01 to 1.02, p=0.0003). When CRP concentrations were stratified by clinically recommended cutpoints, compared with persons with CRP concentrations<1 mg/dl, persons with CRP concentrations between 1 and 3 mg/L and >3 mg/L were 1.15 times (95% CI 0.94 to 1.42) and 1.33 times (95% CI 1.08 to 1.65) more likely to have microalbuminuria, respectively. In subgroup analyses, the strength of association was comparable or stronger. In conclusion, elevated CRP levels were associated with microalbuminuria in a large, nationally representative data set. Vascular inflammation, as measured by CRP, may be a common contributor to early heart and kidney disease.
authors.affiliation: Division of Nephrology and Hypertension, School of Medicine, University of North Carolina, University of North Carolina Kidney Center, Chapel Hill, North Carolina, USA.
authors.forename: Abhijit V
authors.initials: AV
authors.lastname: Kshirsagar
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Bomback
authors.forename: Heejung
authors.initials: H
authors.lastname: Bang
authors.forename: Linda M
authors.initials: LM
authors.lastname: Gerber
authors.forename: Suma
authors.initials: S
authors.lastname: Vupputuri
authors.forename: David A
authors.initials: DA
authors.lastname: Shoham
authors.forename: Madhu
authors.initials: M
authors.lastname: Mazumdar
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.forename: James J
authors.initials: JJ
authors.lastname: Paparello
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Klemmer
mesh_terms: D000419:Albuminuria / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys
chemical_list: D002097:C-Reactive Protein