Urine Albumin-to-Creatinine Ratio Indicates Risk in Rheumatoid Arthritis

THURSDAY, Oct. 10, 2024 (HealthDay News) — For patients with rheumatoid arthritis (RA), urine albumin-to-creatinine ratio (ACR) is an independent risk factor indicating prognosis, according to a study published online Sept. 18 in Frontiers in Immunology.

Zexuan Bin, from The Second Hospital of Shanxi Medical University in Taiyuan, China, and colleagues used 2009 to 2018 data from the National Health and Nutrition Examination Survey to examine whether ACR is an independent risk factor influencing prognosis in RA patients. The cumulative survival probability of RA patients with different urinary albumin excretion was compared.

The researchers found that RA patients with microalbuminuria had a significant increase in all-cause mortality in the Cox regression model adjusted with covariates (hazard ratio, 1.53) and a nonsignificant increase in cardiovascular disease mortality. ACR ≥300 mg/g was associated with increased all-cause and cardiovascular disease mortality (hazard ratios, 2.62 and 5.67, respectively). A nonlinear correlation between ACR and all-cause mortality was seen in RA patients with microalbuminuria in a restricted cubic spline analysis. Cardiovascular disease mortality was higher in RA patients with microalbuminuria who were female; had other ethnicity; and had estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m², hypertension, or hyperlipidemia. ACR provided better prognostic efficacy than eGFR, with higher values of area under the curve for all-cause and cardiovascular disease mortality (0.683 and 0.681, respectively).

“ACR was closely related to the prognosis of RA patients and could be considered as a sensitive and independent indicator for physicians to predict the mortality especially cardiovascular disease mortality in the process of diagnosis and treatment,” the authors write.

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