Research Article| Volume 22, ISSUE 1, P33-37, January 2016

Prevalence of Albuminuria in a General Population Cohort of Patients With Established Chronic Heart Failure


      • The prevalence of albuminuria in adults with established CHF remains unclear.
      • Among adults with CHF, 22.1% and 10.4% had micro- and macroalbuminuria, respectively
      • Adults with CHF had higher odds of albuminuria (odds ratio 1.89, 95% CI 1.59–2.26).



      Numerous studies have reported an association between albuminuria and adverse outcomes in adults with chronic heart failure (CHF). However, the prevalence of albuminuria in adults with established CHF remains unclear.

      Methods and Results

      This study was a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) 1999–2012. Adults aged ≥18 years were included, and diagnosis of CHF was based on participant self-report. The primary outcome was the prevalence of microalbuminuria (albumin-to-creatinine ratio 30–300 mg/g) and macroalbuminuria (albumin-to-creatinine ratio >300 mg/g) in adults with CHF. The secondary outcome was the adjusted odds ratio of any albuminuria in adults with and without CHF. During the study period, 37,961 adults did not have CHF and 1,214 adults had CHF. In adults with CHF, 22.1% (95% confidence interval [CI] 19.6%–24.7%) had microalbuminuria and 10.4% (95% CI 8.1%–12.7%) macroalbuminuria. In adjusted analyses, the odds of albuminuria in adults with CHF was 1.89-fold higher (95% CI 1.59–2.26; P < .001) than in adults without CHF.


      Taken together, albuminuria is more common in adults with CHF than in those without CHF, even after adjustment for important demographic and clinical confounders.

      Key Words

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        • Gerstein H.C.
        • Mann J.F.
        • Yi Q.
        • Zinman B.
        • Dinneen S.F.
        • Hoogwerf B.
        • et al.
        Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals.
        JAMA. 2001; 286: 421-426
        • Hillege H.L.
        • Fidler V.
        • Diercks G.F.H.
        • van Gilst W.H.
        • de Zeeuw D.
        • van Veldhuisen D.J.
        • et al.
        Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population.
        Circulation. 2002; 106: 1777-1782
        • Jackson C.E.
        • Solomon S.D.
        • Gerstein H.C.
        • Zetterstrand S.
        • Olofsson B.
        • Michelson E.L.
        • et al.
        Albuminuria in chronic heart failure: prevalence and prognostic importance.
        Lancet. 2009; 374: 543-550
        • Masson S.
        • Latini R.
        • Milani V.
        • Moretti L.
        • Rossi M.G.
        • Carbonieri E.
        • et al.
        Prevalence and prognostic value of elevated urinary albumin excretion in patients with chronic heart failure: data from the GISSI–Heart Failure trial.
        Circ Heart Fail. 2010; 3: 65-72
        • Miura K.
        • Sekine T.
        • Iida A.
        • Takahashi K.
        • Igarashi T.
        Salt-losing nephrogenic diabetes insipidus caused by fetal exposure to angiotensin receptor blocker.
        Pediatr Nephrol. 2009; 24: 1235-1238
        • Jackson C.E.
        • MacDonald M.R.
        • Petrie M.C.
        • Solomon S.D.
        • Pitt B.
        • Latini R.
        • et al.
        Associations of albuminuria in patients with chronic heart failure: findings in the Aliskiren Observation of Heart Failure Treatment study.
        Eur J Heart Fail. 2011; 13: 746-754
        • Heiat A.
        • Gross C.P.
        • Krumholz H.M.
        Representation of the elderly, women, and minorities in heart failure clinical trials.
        Arch Intern Med. 2002; 162: 1682-1688
        • Cummings P.
        Methods for estimating adjusted risk ratios [internet].
        (Available at:)
        • Zou G.
        A modified poisson regression approach to prospective studies with binary data.
        Am J Epidemiol. 2004; 159: 702-706
        • Lohr S.
        Sampling: design and analysis.
        Cengage Learning, 2009
        • Centers for Disease Control and Prevention (CDC)
        Technical documentation for the 1999–2004 dual energy X-ray absorptiometry (DXA) multiple imputation data files [internet].
        (Available at:)
        • Kistorp C.
        • Chong A.Y.
        • Gustafsson F.
        • Galatius S.
        • Raymond I.
        • Faber J.
        • et al.
        Biomarkers of endothelial dysfunction are elevated and related to prognosis in chronic heart failure patients with diabetes but not in those without diabetes.
        Eur J Heart Fail. 2008; 10: 380-387
        • Miura M.
        • Shiba N.
        • Nochioka K.
        • Takada T.
        • Takahashi J.
        • Kohno H.
        • et al.
        Urinary albumin excretion in heart failure with preserved ejection fraction: an interim analysis of the CHART 2 study.
        Eur J Heart Fail. 2012; 14: 367-376
        • van de Wal R.M.A.
        • Asselbergs F.W.
        • Plokker H.W.T.
        • Smilde T.D.J.
        • Lok D.
        • van Veldhuisen D.J.
        • et al.
        High prevalence of microalbuminuria in chronic heart failure patients.
        J Card Fail. 2005; 11: 602-606
        • Klein R.
        • Klein B.E.
        • Moss S.E.
        Prevalence of microalbuminuria in older-onset diabetes.
        Diabetes Care. 1993; 16: 1325-1330
        • Smilde T.D.J.
        • Damman K.
        • van der Harst P.
        • Navis G.
        • Westenbrink B.D.
        • Voors A.A.
        • et al.
        Differential associations between renal function and “modifiable” risk factors in patients with chronic heart failure.
        Clin Res Cardiol. 2009; 98: 121-129
        • Damman K.
        • van Veldhuisen D.J.
        • Navis G.
        • Voors A.A.
        • Hillege H.L.
        Urinary neutrophil gelatinase associated lipocalin (NGAL), a marker of tubular damage, is increased in patients with chronic heart failure.
        Eur J Heart Fail. 2008; 10: 997-1000