Analysis of data from the Russian AURA registry (real-world data registry on AlbUminuRia detection rate among patients with previously undiAgnosed chronic kidney disease)
https://doi.org/10.15829/1560-4071-2024-5926.
EDN: DSGTSK
Abstract
Aim. To present data from the AURA Registry (real-world data registry on AlbUminuRia detection rate among patients with previously undiAgnosed chronic kidney disease). It is important to perform population studies both to study the occurrence of markers (albuminuria (AU), decreased glomerular filtration rate (GFR)) and the prevalence of chronic kidney disease (CKD), which will provide information on the actual detection rate of CKD and the related markers in territories included in the registry of research centers.
Material and methods. The article presents the first data from the AURA registry. Recruitment was carried out from March 6, 2023 to January 23, 2024. Thirty-four research centers in various federal districts of the Russian Federation and 104 doctors took part in the recruitment. We included 4580 subjects over the age of 40 years who had no previously established diagnosis of CKD and did not have type 1 or type 2 diabetes. During recruitment, the researchers were guided by the AURA study protocol (Version 1.7/12-26-2022).
Results. AU more than 20 mg/g was detected in 64,9% of cases. At the same time, AU is more common at GFR values that may correspond to stage 3A of CKD. The rarer occurrence of AU in those examined with GFR >60 ml/min/1,73 m2 may be explained by less severe renal damage at this CKD stage. The incidence of AU was significantly higher in men, older people, smokers, people with metabolic syndrome, hypertension (HTN), prediabetes and overweight. The occurrence of AU also increased as HTN grade increased. AU detection rate was associated with hypertriglyceridemia, a high blood level of C-reactive protein, which is an integrative marker of inflammation that negatively affects cardiovascular risk.
Conclusion. The presented first data from the AURA registry demonstrated the high AU prevalence in people over 40 years of age. A high incidence of AU was typical for patients with HTN, coronary artery disease, atrial fibrillation, heart failure, and prediabetes. An association has been demonstrated between the high incidence of AU and male sex, age, overweight, hyperuricemia, dyslipidemia, and a number of other cardiovascular risk factors.
About the Authors
M. M. BatyushinRussian Federation
Rostov-on-Don
Competing Interests:
none
M. A. Trubnikova
Russian Federation
Moscow, Sochi
Competing Interests:
none
G. P. Arutyunov
Russian Federation
Moscow
Competing Interests:
none
E. I. Tarlovskaya
Russian Federation
Moscow, Nizhny Novgorod
Competing Interests:
none
A. G. Arutyunov
Armenia
Moscow, Yerevan
Competing Interests:
none
D. S. Polyakov
Russian Federation
Nizhny Novgorod
Competing Interests:
none
S. Sh. Akhmedkhanov
Russian Federation
Makhachkala
Competing Interests:
none
I. G. Bakulin
Russian Federation
St. Petersburg
Competing Interests:
none
I. A. Bodrievskaya
Russian Federation
Nizhny Novgorod
Competing Interests:
none
I. A. Viktorova
Russian Federation
Omsk
Competing Interests:
none
N. G. Vinogradova
Russian Federation
Nizhny Novgorod
Competing Interests:
none
A. S. Galyavich
Russian Federation
Kazan
Competing Interests:
none
N. P. Garganeeva
Russian Federation
Tomsk
Competing Interests:
none
N. Yu. Grigorieva
Russian Federation
Nizhny Novgorod
Competing Interests:
none
S. B. Erofeeva
Russian Federation
Moscow
Competing Interests:
none
M. A. Kercheva
Russian Federation
Tomsk
Competing Interests:
none
S. G. Kechedzhieva
Russian Federation
Stavropol
Competing Interests:
none
N. A. Koryagina
Russian Federation
Perm
Competing Interests:
none
S. V. Malchikova
Russian Federation
Kirov
Competing Interests:
none
V. A. Nevzorova
Russian Federation
Vladivostok
Competing Interests:
none
S. V. Nedogoda
Russian Federation
Volgograd
Competing Interests:
все авторы заявляют об отсутствии потенциального конфликта интересов, требующего раскрытия в данной статье
M. M. Petrova
Russian Federation
Krasnoyarsk
Competing Interests:
none
V. A. Pogrebetskaya
Russian Federation
Nizhny Novgorod
Competing Interests:
none
A. P. Rebrov
Russian Federation
Saratov
Competing Interests:
none
O. A. Rubanenko
Russian Federation
Samara
Competing Interests:
none
E. A. Safianik
Russian Federation
Yekaterinburg
Competing Interests:
none
V. V. Skibitsky
Russian Federation
Krasnodar
Competing Interests:
none
E. A. Smirnova
Russian Federation
Ryazan
Competing Interests:
none
E. A. Starovoitova
Russian Federation
Tomsk
Competing Interests:
none
R. F. Khamitov
Russian Federation
Kazan
Competing Interests:
none
A. I. Chesnikova
Russian Federation
Rostov-on-Don
Competing Interests:
none
T. M. Shabatina
Russian Federation
Moscow
Competing Interests:
none
I. I. Shaposhnik
Russian Federation
Chelyabinsk
Competing Interests:
none
A. R. Vaisberg
Russian Federation
Nizhny Novgorod
Competing Interests:
none
A. V. Aparkina
Russian Federation
Saratov
Competing Interests:
none
I. N. Barykina
Russian Federation
Volgograd
Competing Interests:
none
T. I. Batluk
Russian Federation
Moscow
Competing Interests:
none
R. A. Bashkinov
Russian Federation
Moscow, St. Petersburg
Competing Interests:
none
A. T. Beybalayeva
Russian Federation
Makhachkala
Competing Interests:
none
Y. A. Belenikina
Russian Federation
Ryazan
Competing Interests:
none
O. A. Bilevich
Russian Federation
Omsk
Competing Interests:
none
Zh. V. Bondareva
Russian Federation
Vladivostok
Competing Interests:
none
A. Yu. Vaskin
Russian Federation
Moscow
Competing Interests:
none
T. V. Vlasova
Russian Federation
Nizhny Novgorod
Competing Interests:
none
E. V. Galko
Russian Federation
Krasnoyarsk
Competing Interests:
none
T. U. Garifullin
Russian Federation
St. Petersburg
Competing Interests:
none
E. D. Gordeychuk
Russian Federation
Moscow
Competing Interests:
none
E. V. Grigorieva
Russian Federation
Saratov
Competing Interests:
none
I. V. Gubareva
Russian Federation
Samara
Competing Interests:
none
L. K. Danilova
Russian Federation
Krasnoyarsk
Competing Interests:
none
A. I. Dolgushina
Russian Federation
Chelyabinsk
Competing Interests:
none
E. M. Durygina
Russian Federation
Nizhny Novgorod
Competing Interests:
none
D. S. Evdokimov
Russian Federation
St. Petersburg
Competing Interests:
none
N. V. Zhdankina
Russian Federation
Nizhny Novgorod
Competing Interests:
none
E. I. Zheleznyak
Russian Federation
Rostov-on-Don
Competing Interests:
none
D. S. Zueva
Russian Federation
St. Petersburg
Competing Interests:
none
D. S. Ivanova
Russian Federation
Omsk
Competing Interests:
none
E. Yu. Ivanchenko
Russian Federation
Nizhny Novgorod
Competing Interests:
none
M. V. Kazakovtseva
Russian Federation
Kirov
Competing Interests:
none
A. A. Kaznina
Russian Federation
Nizhny Novgorod
Competing Interests:
none
N. A. Karoli
Russian Federation
Saratov
Competing Interests:
none
D. S. Kaskaeva
Russian Federation
Krasnoyarsk
Competing Interests:
none
Z. F. Kim
Russian Federation
Kazan
Competing Interests:
none
M. V. Kozlova
Russian Federation
Nizhny Novgorod
Competing Interests:
none
Y. I. Kudrinskaya
Russian Federation
Chelyabinsk
Competing Interests:
none
A. S. Kuznetsova
Russian Federation
Chelyabinsk
Competing Interests:
none
E. Yu. Levchenko
Russian Federation
St. Petersbur
Competing Interests:
none
I. A. Lukonin
Russian Federation
Krasnodar
Competing Interests:
none
V. O. Lutova
Russian Federation
Volgograd
Competing Interests:
none
N. A. Magdeeva
Russian Federation
Saratov
Competing Interests:
none
E. V. Makarova
Russian Federation
Nizhny Novgorod
Competing Interests:
none
N. E. Makarova
Russian Federation
Nizhny Novgorod
Competing Interests:
none
M. M. Mamontova
Russian Federation
Krasnoyarsk
Competing Interests:
none
E. S. Melnikov
Russian Federation
Moscow, St. Petersburg
Competing Interests:
none
A. F. Molostvova
Russian Federation
Kazan
Competing Interests:
none
T. D. Naborshchikova
Russian Federation
St. Petersburg
Competing Interests:
none
I. N. Nikitina
Russian Federation
Ryazan
Competing Interests:
none
D. P. Novikova
Russian Federation
Krasnoyarsk
Competing Interests:
none
M. V. Novikova
Russian Federation
Stavropol
Competing Interests:
none
V. I. Pakusina
Russian Federation
Nizhny Novgorod
Competing Interests:
none
K. G. Pereverzeva
Russian Federation
Ryazan
Competing Interests:
none
I. S. Pleshakov
Russian Federation
Samara
Competing Interests:
none
Yu. G. Pokramovich
Russian Federation
Moscow
Competing Interests:
none
O. V. Ponomareva
Russian Federation
Ryazan
Competing Interests:
none
E. A. Popova
Russian Federation
Volgograd
Competing Interests:
none
N. A. Popova
Russian Federation
Nizhny Novgorod
Competing Interests:
none
E. S. Potapova
Russian Federation
Vladivostok
Competing Interests:
none
E. D. Resnyanskaya
Russian Federation
St. Petersburg
Competing Interests:
none
M. Yu. Rozhkova
Russian Federation
Omsk
Competing Interests:
none
A. O. Rubanenko
Russian Federation
Samara
Competing Interests:
none
M. D. Rudoy
Russian Federation
Nizhny Novgorod
Competing Interests:
none
A. S. Salasyuk
Russian Federation
Volgograd
Competing Interests:
none
L. M. Salimova
Russian Federation
Kazan
Competing Interests:
none
V. I. Samokhina
Russian Federation
Ryazan
Competing Interests:
none
N. Sh. Sanginova
Russian Federation
Nizhny Novgorod
Competing Interests:
none
F. I. Sattarova
Russian Federation
Kazan
Competing Interests:
none
A. Kh. Safina
Russian Federation
Kazan
Competing Interests:
none
D. P. Sirotenko
Russian Federation
Omsk
Competing Interests:
none
N. S. Skarzhinskaya
Russian Federation
Rostov-on-Don
Competing Interests:
none
A. V. Skibitsky
Russian Federation
Krasnodar
Competing Interests:
none
E. I. Suchkova
Russian Federation
Ryazan
Competing Interests:
none
L. E. Tepnadze
Russian Federation
Krasnoyarsk
Competing Interests:
none
A. V. Fendrikova
Russian Federation
Krasnodar
Competing Interests:
none
T. E. Filatova
Russian Federation
Ryazan
Competing Interests:
none
O. V. Filyushin
Russian Federation
Ryazan
Competing Interests:
none
O. Yu. Chizhova
Russian Federation
St. Petersburg
Competing Interests:
none
T. I. Chudinovskikh
Russian Federation
Kirov
Competing Interests:
none
S. S. Yakushin
Russian Federation
Ryazan
Competing Interests:
none
E. M. Yashina
Russian Federation
Nizhny Novgorod
Competing Interests:
none
References
1. Lees JS, Welsh CE, Celis-Morales CA, et al. Glomerular filtration rate by differing mea sures, albuminuria and prediction of cardiovascular disease, mortality and endstage kidney disease. Nat Med. 2019;25(11):175360. doi:10.1038/s41591019-06278.
2. Matsushita K, Coresh J, Sang Y, et al. CKD Prognosis Consortium. Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative metaanalysis of individual participant data. Lancet Diabetes Endocrinol. 2015;3(7):51425. doi:10.1016/S22138587(15)000406.
3. Sumida K, Nadkarni GN, Grams ME, et al. Chronic Kidney Disease Prognosis Consortium. Conversion of Urine Protein-Creatinine Ratio or Urine Dipstick Protein to Urine Albumin-Creatinine Ratio for Use in Chronic Kidney Disease Screening and Prognosis: An Individual Participant-Based Metaanalysis. Ann Intern Med. 2020;173(6):42635. doi:10.7326/M200529.
4. Leong SO, Lui KF, Ng WY, et al. The use of semiquantitative urine teststrip (Micral Test) for microalbuminuria screening in patients with diabetes mellitus. Singapore Med J. 1998;39(3):1013.
5. Matsushita K, van der Velde M, Astor BC, et al. Chronic Kidney Disease Prognosis Consortium; Association of estimated glomerular filtration rate and albuminuria with allcause and cardiovascular mortality in general population cohorts: a collaborative metaanalysis. Lancet. 2010;375(9731):207381. doi:10.1016/S01406736(10)606745.
6. Ärnlöv J, Nowak C. Association between albuminuria, incident cardiovascular events, and mortality in persons without hypertension, diabetes, and cardiovascular disease. Eur J Prev Cardiol. 2022;29(1):e4e6. doi:10.1093/eurjpc/zwaa095.
7. Marques da Silva P, Carvalho D, Nazaré J, et al. Prevalence of microalbuminuria in hypertensive patients with or without type 2 diabetes in a Portuguese primary care setting: The RACE (micRoAlbumin sCreening survEy) study. Rev Port Cardiol. 2015;34(4):23746. English, Portuguese. doi:10.1016/j.repc.2014.08.017.
8. Dobronravov VA, Smirnov AV, Kayukov IG. Manysided albuminuria: aspects of clinical value. Nephrology (Saint-Petersburg). 2009;13(3):338. (In Russ.)
9. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International. 2024;105(Suppl 4S):S117S314. doi:10.1016/j.kint.2023.10.018.
10. Essaian AM, Arutyunov GP, Melikhov OG. Prevalence of chronic kidney disease in primary care patients. results of a prospective observational study in 12 regions of Russia. Clinical Nephrology. 2021;3:616. (In Russ.) doi:10.18565/nephrology.2021.3.616.
11. Batyushin MM, Gavrilov DV, Gusev AV, et al. Prevalence of chronic kidney disease according to the retrospective cohort study "Epidemiology of CKD" (Kirov city). Nephrology and dialysis. 2021;23(2):192202. (In Russ.)
12. Arutyunov AG, Batyushin MM, Arutyunov GP, et al. Real Clinical Practice Register of Albuminuria Detection in Patients with Previously Undiagnosed Chronic Kidney Disease. The Russian Archives of Internal Medicine. 2023;13(6):44954. (In Russ.) doi:10.20514/222667042023136449454.
13. Kobalava ZhD, Villevalde SV, Bagmanova NKh, et al. the prevalence of chronic kidney disease markers in arterial hypertension patients and relation with diabetes: results of epidemiological study khronograph. Russian Journal of Cardiology. 2018;(2):91101. (In Russ.) doi:10.15829/156040712018291101.
14. Oschepkova EV, Aksenova AV, Orlovsky AА, Chazova IE. Chronic kidney disease in outpatients with arterial hypertension: clinical characteristics and treatment efficacy (according to the national registry). Terapevticheskii arkhiv. 2022;94(7):8105. (In Russ.) doi:10.26442/00403660.2022.07.201744.
15. Ivanov VP, Savicjka Yu V. Renal function in patients with systolic chronic heart failure depending on quality of life. Heart and blood vessels. 2016;4(56):6671.
16. Khan MS, Shahid I, Anker SD, et al. Albuminuria and Heart Failure: JACC Stateofthe-Art Review. J Am Coll Cardiol. 2023;81(3):27082. doi:10.1016/j.jacc.2022.10.028.
17. Oye-Somefun A, Kuk JL, Ardern CI. Associations between elevated kidney and liver bio marker ratios, metabolic syndrome and allcause and coronary heart disease (CHD) mortality: analysis of the U. S. National Health and Nutrition Examination Survey (NHANES). BMC Cardiovasc Disord. 2021;21(1):352. doi:10.1186/s1287202102160w.
18. Zanetti D, Bergman H, Burgess S, et al. Urinary Albumin, Sodium, and Potassium and Cardiovascular Outcomes in the UK Biobank: Observational and Mendelian Randomization Analyses. Hypertension. 2020;75(3):71422. doi:10.1161/HYPERTENSIONAHA.119.14028.
19. Bolotova EV, Dudnikova AV, Yavlyanskaya VV. Features of chronic kidney disease diagno-sis in patient chronic obstructive pulmonary disease. Clinical nephrology. 2017;(1):1822. (In Russ.) doi:20753594/article/view/272630.
20. Agranovich NV, Pilipovich LA, Albotova LV. Prognostic significance of some markers of end othelial dysfunction in the development of chronic kidney pathology in chronic obstructive pulmonary disease. Nephrology (Saint-Petersburg). 2018;22(5):2530. (In Russ.) doi:10.24884/1561627420182252530.
21. Kaspar CDW, Lu J. Hyperuricemia, Elevated Body Mass Index, Female Sex, and Albuminuria Increase the Probability of Elevated High-Sensitivity CReactive Protein: Results From the National Health and Nutrition Examination Survey 20152018. Front Public Health. 2021;9:689219. doi:10.3389/fpubh.2021.689219.
22. Rizk JG, Hsiung JT, Arif Y, et al. Triglycerides and Renal Outcomes According to Albuminuria and in Consideration of Other Metabolic Syndrome Components in Diabetic US Veterans. Am J Nephrol. 2023;54(12):1424. doi:10.1159/000529414.
23. Podzolkov VI, Bragina AE, Druzhinina NA, et al. Relation between Tobacco Smoking/Electronic Smoking and Albuminuria/Vascular Stiffness in Young People without Cardiovascular Diseases. Kidney Blood Press Res. 2020;45(3):46776. doi:10.1159/000507510.
24. Polshakova IL, Povetkin SV. Drug Therapy Structure and Clinical Characteristics of Pa tients with Atrial Fibrillation According to Data of REKURAF Study. Rational Pharmacotherapy in Cardiology. 2018;14(5):73340. (In Russ.) doi:10.20996/181964462018145733740.
25. Bansal N, Zelnick LR, Alonso A, et al. eGFR and Albuminuria in Relation to Risk of Incident Atrial Fibrillation: A Meta-Analysis of the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study. Clin J Am Soc Nephrol. 2017;12(9):138698. doi:10.2215/CJN.01860217.
26. Shilpasree AS, Patil VS, Revanasiddappa M, et al. Renal Dysfunction in Prediabetes: Con firmed by Glomerular Hyperfiltration and Albuminuria. J Lab Physicians. 2021;13(3): 25762. doi:10.1055/s00411731107.
27. Kar D, El-Wazir A, Delanerolle G, et al. Predictors and determinants of albuminuria in people with prediabetes and diabetes based on smoking status: A cross-sectional study using the UK Biobank data. EClinicalMedicine. 2022;51:101544. doi:10.1016/j.eclinm.2022.101544.
28. Ali MK, Bullard KM, Saydah S, et al. Cardiovascular and renal burdens of prediabetes in the USA: analysis of data from serial cross-sectional surveys, 19882014. Lancet Diabetes Endocrinol. 2018;6(5):392403. doi:10.1016/S22138587(18)300275.
Supplementary files
- The paper presents the first results of the AURA real-world data registry.
- A group of people with previously undiagnosed chronic kidney disease was identified, who had a higher incidence of albuminuria and no diabetes of any type.
- Albuminuria was more common in males, over 40 years of age, with metabolic syndrome, hypertension and other cardiovascular diseases.
Review
For citations:
Batyushin M.M., Trubnikova M.A., Arutyunov G.P., Tarlovskaya E.I., Arutyunov A.G., Polyakov D.S., Akhmedkhanov S.Sh., Bakulin I.G., Bodrievskaya I.A., Viktorova I.A., Vinogradova N.G., Galyavich A.S., Garganeeva N.P., Grigorieva N.Yu., Erofeeva S.B., Kercheva M.A., Kechedzhieva S.G., Koryagina N.A., Malchikova S.V., Nevzorova V.A., Nedogoda S.V., Petrova M.M., Pogrebetskaya V.A., Rebrov A.P., Rubanenko O.A., Safianik E.A., Skibitsky V.V., Smirnova E.A., Starovoitova E.A., Khamitov R.F., Chesnikova A.I., Shabatina T.M., Shaposhnik I.I., Vaisberg A.R., Aparkina A.V., Barykina I.N., Batluk T.I., Bashkinov R.A., Beybalayeva A.T., Belenikina Y.A., Bilevich O.A., Bondareva Zh.V., Vaskin A.Yu., Vlasova T.V., Galko E.V., Garifullin T.U., Gordeychuk E.D., Grigorieva E.V., Gubareva I.V., Danilova L.K., Dolgushina A.I., Durygina E.M., Evdokimov D.S., Zhdankina N.V., Zheleznyak E.I., Zueva D.S., Ivanova D.S., Ivanchenko E.Yu., Kazakovtseva M.V., Kaznina A.A., Karoli N.A., Kaskaeva D.S., Kim Z.F., Kozlova M.V., Kudrinskaya Y.I., Kuznetsova A.S., Levchenko E.Yu., Lukonin I.A., Lutova V.O., Magdeeva N.A., Makarova E.V., Makarova N.E., Mamontova M.M., Melnikov E.S., Molostvova A.F., Naborshchikova T.D., Nikitina I.N., Novikova D.P., Novikova M.V., Pakusina V.I., Pereverzeva K.G., Pleshakov I.S., Pokramovich Yu.G., Ponomareva O.V., Popova E.A., Popova N.A., Potapova E.S., Resnyanskaya E.D., Rozhkova M.Yu., Rubanenko A.O., Rudoy M.D., Salasyuk A.S., Salimova L.M., Samokhina V.I., Sanginova N.Sh., Sattarova F.I., Safina A.Kh., Sirotenko D.P., Skarzhinskaya N.S., Skibitsky A.V., Suchkova E.I., Tepnadze L.E., Fendrikova A.V., Filatova T.E., Filyushin O.V., Chizhova O.Yu., Chudinovskikh T.I., Yakushin S.S., Yashina E.M. Analysis of data from the Russian AURA registry (real-world data registry on AlbUminuRia detection rate among patients with previously undiAgnosed chronic kidney disease). Russian Journal of Cardiology. 2024;29(7):5926. (In Russ.) https://doi.org/10.15829/1560-4071-2024-5926.. EDN: DSGTSK