Proteinuria as an independent predictor of stroke: Systematic review and meta-analysis
Key result
Proteinuria was independently associated with a greater risk of incident stroke (adjusted RR 1.72; 95% CI 1.51-1.95; P<0.001), even after extensive adjustment for hypertension.
Why the study?
Hypertension has been proposed as the principal confounder of the relationship between proteinuria and stroke, but its role had not been systematically examined.
Does the presence of proteinuria predict incident stroke risk independently of hypertension in adults?
Population
1,735,390 participants across 38 studies
Comparison
Presence of any level of proteinuria vs absence of proteinuria
Design
Systematic review and meta-analysis of cohort studies and randomized controlled trials
Authors
Discussion
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Member takes
Implication
Proteinuria marks higher stroke risk beyond hypertension; supports its use in risk models and further causal studies.
Study Design
Type
Systematic Review (n=1,735,390)
Structured PICO
Does the presence of proteinuria predict incident stroke risk independently of hypertension in adults?
P
Population
1,735,390 adults from 38 studies assessing the association between baseline proteinuria and incident stroke risk.
E
Exposure
Presence of any level of proteinuria
C
Comparator
Absence of proteinuria
O
Outcome
Stroke incidencehard clinical
Main Result
Relative Risk: 1.72 (95% CI 1.51–1.95)
p-value: p=<0.001
Proteinuria is strongly and independently associated with incident stroke risk, even after extensive adjustment for hypertension, suggesting it is a robust independent vascular risk factor.
Limitations
- Considerable heterogeneity between studies (I2 = 77.3%)
Cite This Study
Kelly et al. (2020) conducted a systematic review in Stroke (n=1,735,390). Proteinuria vs. No proteinuria was evaluated on Stroke incidence (RR 1.72, 95% CI 1.51-1.95, p=<0.001). Proteinuria was independently associated with a greater risk of incident stroke (adjusted RR 1.72; 95% CI 1.51-1.95; P<0.001), even after extensive adjustment for hypertension.