Key result
Higher uACR is linked to a ~0.10 m/s increase in brachial-ankle PWV.
Why the study?
Very low-grade albuminuria has been linked to adverse outcomes, but its association with arterial stiffness in the general population, particularly without major cardiometabolic disease, remains uncertain.
Is very low-grade albuminuria associated with increased arterial stiffness in the general population?
Cohort (n=7,613)
Is very low-grade albuminuria associated with increased arterial stiffness in the general population?
Even very low-grade albuminuria (uACR <30 mg/g) is independently associated with increased arterial stiffness, including in individuals without hypertension or diabetes.
VLGA may flag early vascular risk even without cardiometabolic disease; leaves open whether targeting it alters stiffness or outcomes.
Background : Albuminuria even at low levels and increased arterial stiffness are associated with higher cardiovascular risk. Very low-grade albuminuria (VLGA; urinary albumin–creatinine ratio [uACR] <30 mg/g) has been linked to adverse outcomes, but its association with arterial stiffness in the general population, particularly among individuals without major cardiometabolic disease, remains uncertain. Methods : We analyzed data from 7,613 participants of the German National Cohort (NAKO) with available uACR and brachial–ankle pulse wave velocity (PWV[ba]) measurements. Multivariable linear regression was used to assess the association between log₁₀-transformed uACR and PWV(ba), adjusting for age, sex, systolic blood pressure, obesity indices, LDL-cholesterol, HbA1c, and estimated glomerular filtration rate (eGFR). A low-risk subgroup excluded participants with arterial hypertension or diabetes mellitus. Results : Among included participants, 49.6% were female and 7,100 (93.3%) had uACR <30 mg/g. In the full cohort, a 10-fold higher uACR was associated with higher PWV(ba) by 0.10 m/s (95% CI 0.03–0.17). Similar associations were observed in the VLGA subgroup (0.16 m/s; 95% CI 0.07–0.25). In the low-risk VLGA subgroup (n = 4,308), uACR remained positively associated with PWV(ba) (0.18 m/s per 10-fold higher uACR; 95% CI 0.08–0.28). Conclusion : Higher uACR was consistently associated with greater arterial stiffness across the full cohort and among individuals with very low-grade albuminuria, including those without arterial hypertension or diabetes mellitus.
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Walendy et al. (2026) conducted a cohort in General population (n=7,613). Higher urinary albumin-creatinine ratio (uACR) was evaluated on Brachial-ankle pulse wave velocity (PWV[ba]) (MD 0.10 m/s, 95% CI 0.03-0.17).
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