Introduction: Non-albumin proteinuria (NAP), the presence of proteins other than albumin in urine, involves a wide range of urinary proteins that reflect mainly tubular injury and is reported to be associated with mortality in hospital settings.This study examined the association of NAP with all-cause mortality, compared with albuminuria and proteinuria, in community-dwelling adults.Methods: A community-based prospective cohort study conducted in Japan included 6,601 participants (aged 40-97 years, 48.0% women).We assessed NAP as the difference between the urine albumin-tocreatinine ratio (ACR) and the urine protein-to-creatinine ratio (PCR).The associations of NAP, ACR, and PCR with all-cause mortality and secondarily cause of death were assessed by multivariable Cox hazard regression analysis with adjustment for potential confounders.Results: The median NAP, ACR, and PCR values were 27.3 mg/g, 11.0 mg/g, and 40.8 mg/g, respectively, with a median eGFR of 73.7 mL/ min/1.73m 2 .During a median follow-up of 11.2 years, 1,182 events occurred.For a doubling of NAP, ACR, and PCR, the adjusted hazard ratios (95% CI) for all-cause mortality were 1. 16 (1.11,1.21), 1.12 (1.08, 1.16), and 1.18 (1.13, 1.23), respectively.When further adjusted for ACR levels, NAP was significantly associated with all-cause mortality (adjusted hazard ratio 95% CI, 1.12 1.06, 1.18).NAP demonstrated a similar positive association with cardiovascular mortality.Conclusion: This prospective study found a positive association between NAP and all-cause mortality independent of ACR levels in community-dwelling adults.NAP can be a useful potential marker for identifying high-risk populations for mortality, regardless of albuminuria levels.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.
Little et al. (Wed,) studied this question.