Abstract: SA-PO1127
Association of Albuminuria with Interstitial Lung Abnormalities
Session Information
- CKD Epidemiology, Risk Factors, Prevention - III
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Husain-Syed, Faeq, University of Virginia, Charlottesville, Virginia, United States
- Mallawaarachchi, Indika V., University of Virginia, Charlottesville, Virginia, United States
- Ma, Jennie Z., University of Virginia, Charlottesville, Virginia, United States
- Debban, Catherine, University of Virginia, Charlottesville, Virginia, United States
- Hoffman, Eric A., University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
- McGroder, Claire, Columbia University Irving Medical Center, New York, New York, United States
- Anderson, Michaela R., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Raghu, Ganesh, University of Washington, Seattle, Washington, United States
- Kawut, Steven, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Podolanczuk, Anna J., Weill Cornell Medicine, New York, New York, United States
- Manichaikul, Ani W., University of Virginia, Charlottesville, Virginia, United States
- Rich, Stephen R., University of Virginia, Charlottesville, Virginia, United States
- Garcia, Christine Kim, Columbia University Irving Medical Center, New York, New York, United States
- Oelsner, Elizabeth C., Columbia University Irving Medical Center, New York, New York, United States
- Scialla, Julia J., University of Virginia, Charlottesville, Virginia, United States
- Barr, R. Graham, Columbia University Irving Medical Center, New York, New York, United States
- Kim, John, University of Virginia, Charlottesville, Virginia, United States
Background
Pulmonary microvascular dysfunction has been implicated in the pathogenesis of pulmonary fibrosis. Albuminuria, a marker of endothelial dysfunction, may be a risk factor in the early development of interstitial lung disease (ILD). We hypothesized that higher UACR would be associated with interstitial lung abnormalities (ILA), which may represent early stages of pulmonary fibrosis.
Methods
A subset of the U.S. population-based Multi-Ethnic Study of Atherosclerosis cohort (n = 2,260) had spot UACR and full-lung CT measurements at Exam 5 (2010–2012). The association between UACR and ILA was examined cross-sectionally using a generalized linear mixed model accounting for clustering by study site. Due to potential differential associations by age, we performed a stratified analysis with an age cutoff of 65 years. Kaplan-Meier estimation was used to examine whether UACR modified the association of ILA with all-cause mortality (2010–2019).
Results
Compared to participants without ILA, those with ILA (11.8%) were older (74.2±9.1 vs. 68.2±9.0 years), had higher UACR levels (8.4 [IQR, 4.0–20.3] vs. 5.8 [3.5–12.6] mg/g creatinine), and a higher prevalence of smoking history. After adjustment for covariates, UACR was not associated with ILA in the overall group (P=0.71). An association was observed in the age≥65 (OR=1.17, 95% CI: 1.06–1.29; P=0.002) but not in the age<65 group (P=0.88). Adjustment for age in stratified analysis did not change the estimates considerably. The presence of both ILA and higher UACR (≥10 mg/g) was associated with greater risk of death when compared with fulfilling only one or none of the two criteria (Figure; log-rank P<0.001).
Conclusion
Albuminuria was associated with more ILA and worse survival in older community-dwelling adults. Albuminuria may be a risk factor in early ILD and requires further investigation.
Funding
- Other NIH Support