title: Urinary albumin-creatinine ratio, estimated glomerular filtration rate, and all-cause mortality among US adults with obstructive lung function.
abstract: BACKGROUND
  Elevated urinary albumin-creatinine ratio (UACR) and decreased estimated glomerular filtration rate (eGFR) predict all-cause mortality, but whether these markers of kidney damage and function do so in adults with obstructive lung function (OLF) is unclear. The objective of this study was to examine the associations between UACR and eGFR and all-cause mortality in adults with OLF.
  
  
  METHODS
  Data of 5,711 US adults aged 40 to 79 years, including 1,390 adults with any OLF who participated in the National Health and Nutrition Examination Survey III (1988-1994), were analyzed. Mortality follow-up was conducted through 2006.
  
  
  RESULTS
  During the median follow-up of 13.7 years, 650 adults with OLF died. After maximal adjustment, mean levels of UACR were higher in adults with moderate-severe OLF (7.5 mg/g; 95% CI, 6.7-8.5) than in adults with normal pulmonary function (6.2 mg/g; 95% CI, 5.8-6.6) (P = .003) and mild OLF (6.2 mg/g; 95% CI, 5.5-6.9) (P = .014). Adjusted mean levels of eGFR were lower in adults with moderate-severe OLF (87.6 mL/min/1.73 m²; 95% CI, 86.0-89.1) than in adults with normal lung function (89.6 mL/min/1.73 m²; 95% CI, 88.9-90.3) (P = .015). Among adults with OLF, hazard ratios for all-cause mortality increased as levels of UACR, modeled as categorical or continuous variables, increased (maximally adjusted hazard ratio for quintile 5 vs 1: 2.23; 95% CI, 1.56-3.18). eGFR, modeled as a continuous variable but not as quintiles, was significantly associated with mortality.
  
  
  CONCLUSIONS
  UACR and eGFR, in continuous form, were associated with all-cause mortality among US adults with OLF.
authors: Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.. Electronic address: eford@cdc.gov.
authors: Earl S
authors: ES
authors: Ford
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000401:mortality / Q000503:physiopathology / Q000652:urine*; D002423:Cause of Death / Q000639:trends; D003404:Creatinine / Q000652:urine*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000401:mortality* / Q000652:urine; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: D003404:Creatinine