{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T08:38:08Z","timestamp":1790757488548,"version":"4.1.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"17","license":[{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R38HL143584"],"award-info":[{"award-number":["R38HL143584"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of this study is to determine whether elevated levels of albuminuria within the low range [urinary albumin-to-creatinine ratio (UACR) &amp;lt;30\u2005mg\/g] are linked to cardiovascular death in adults lacking major cardiovascular risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The association between UACR and cardiovascular mortality was investigated among 12 835 participants in the 1999\u20132014 National Health and Nutrition Examination Survey using Cox proportional hazard models and confounder-adjusted survival curves. We excluded participants with baseline cardiovascular disease, hypertension, diabetes, pre-diabetes, an estimated glomerular filtration rate &amp;lt;60\u2005mL\/min\/1.73\u2005m2, currently pregnant, and those who received dialysis last year. Over a median follow-up of 12.3 years, 110 and 621 participants experienced cardiovascular and all-cause mortality. In multivariable-adjusted models, each doubling of UACR was associated with a 36% higher risk of cardiovascular death [hazard ratio (HR) 1.36, 95% confidence interval (CI) 1.02\u20131.82] and a 24% higher risk of all-cause mortality (HR 1.24, 95% CI 1.10\u20131.39). The 15-year adjusted cumulative incidences of cardiovascular mortality were 0.91, 0.99, and 2.1% for UACR levels of &amp;lt;4.18, 4.18 to &amp;lt;6.91, and \u22656.91\u2005mg\/g, respectively. The 15-year adjusted cumulative incidences of all-cause mortality were 5.1, 6.1, and 7.4% for UACR levels of &amp;lt;4.18, 4.18 to &amp;lt;6.91, and \u22656.91\u2005mg\/g, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adults with elevated levels of albuminuria within the low range (UACR &amp;lt;30\u2005mg\/g) and no major cardiovascular risk factors had elevated risks of cardiovascular and all-cause mortality. The risk increased linearly with higher albuminuria levels. This emphasizes a risk gradient across all albuminuria levels, even within the supposedly normal range, adding to the existing evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwae189","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T15:48:40Z","timestamp":1717170520000},"page":"2046-2055","source":"Crossref","is-referenced-by-count":24,"title":["The relationship between low levels of albuminuria and mortality among adults without major cardiovascular risk factors"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7695-4674","authenticated-orcid":false,"given":"Sophie E","family":"Claudel","sequence":"first","affiliation":[{"name":"Department of Medicine, Boston Medical Center , 72 E. 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Nephrology, Department of Medicine, Boston Medical Center , 650 Albany Street, Boston, MA 02118 ,","place":["USA"]},{"name":"Hamburg Center for Kidney Health, University Medical Center Hamburg , Martinistrase 52 Campus Research N27, Hamburg 20246 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7357-5970","authenticated-orcid":false,"given":"Ramachandran S","family":"Vasan","sequence":"additional","affiliation":[{"name":"Section of Nephrology, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine , X-521, 650 Albany Street, Boston, MA 02118 ,","place":["USA"]},{"name":"Department of Quantitative and Qualitative Health Sciences, University of Texas School of Public Health and University of Texas Health Science Center in San Antonio , San Antonio, TX 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