title: Serum Albumin and High-Sensitivity C-reactive Protein are Independent Risk Factors of Chronic Kidney Disease in Middle-Aged Japanese Individuals: the Circulatory Risk in Communities Study.
abstract: OBJECTIVE
  It is important to explore predictive markers other than conventional cardiovascular risk factors for early detection and treatment of chronic kidney disease (CKD), a major risk factor for end-stage renal failure. We hypothesized that serum albumin and high-sensitivity C-reactive protein (hs-CRP) to be independent markers, and examined their associations with the risk of CKD.
  
  
  METHODS
  We examined the associations of serum albumin and hs-CRP levels with the risk of incident CKD, in 2535 Japanese adults aged 40-69 years without CKD at baseline during a median 9.0-year follow-up after adjustment for known cardiovascular risk factors.
  
  
  RESULTS
  During the follow-up period, 367 cases of CKD developed. In multivariable analyses adjusted for known risk factors, the CKD hazard ratios (95% confidence intervals) for the highest versus lowest quartiles of serum albumin levels were 0.69 (0.40-1.17) for men and 0.42 (0.28-0.64) for women. Corresponding values for hs-CRP were 0.95 (0.54-1.67) for men and 1.85 (1.25-2.75) for women. The association of combined serum albumin and hs-CRP with the risk of CKD was examined for women. The hazard ratio was 1.72 (1.17-2.54) for low versus higher albumin levels at lower hs-CRP levels, but such an association was not observed at high hs-CRP level. The hazard ratio was 1.96 (1.44-2.66) for high versus lower hs-CRP levels at higher serum albumin levels, but such association was not observed at low serum albumin level.
  
  
  CONCLUSIONS
  Both low serum albumin and high hs-CRP levels were predictive of CKD for women.
authors.affiliation: Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.
authors.forename: Sachimi
authors.initials: S
authors.lastname: Kubo
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kitamura
authors.forename: Hironori
authors.initials: H
authors.lastname: Imano
authors.forename: Renzhe
authors.initials: R
authors.lastname: Cui
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Yamagishi
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Umesawa
authors.forename: Isao
authors.initials: I
authors.lastname: Muraki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kiyama
authors.forename: Takeo
authors.initials: T
authors.lastname: Okada
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; D002097:C-Reactive Protein