The presence of albuminuria and the decrease of glomerular filtration (GFR) are indexes used to assess renal function, even if the values of normality levels are still debated. In order to clear up in a better way the problem and to verify also the influence of these parameters on mortality, a meta-analysis has been performed on 21 trials, involving about 1,200,000 patients: for over 100,000 of them it was possible to obtain the value of albumin/creatinine relation. Mortality risk was kept almost unchanging for GFR values between 75 and 105 ml/min/1.73 m2. HR (Hazard Ratio), instead, for mortality for any cause has been of 1.18, 1.57 and 3.14 for GFR values respectively of 60, 45 and 15 ml/min/1.73 m2. Examining the relation between the risk of overall morality and albumin/creatinine relation it was seen, instead, that, compared to a starting value of 5 mg/g, the increase in the relation at 10, 30 and 300 mg/g has implied a HR respectively of 1.20, 1.63 e 2.22. Albuminuria measurement through stick has given practically identical values compared to the ones obtained through the calculation of albumin/creatinine relation. Cardiovascular mortality reflects the overall one. The association between GFR and mortality was similar for all the considered values of albumin/creatinine and vice versa, that suggests there are independent risk factors for the two parameters, risk factors which have been completely independent from the other factors of cardiovascular risk.
The very wide trial confirms that albuminuria alone (a parameter which can be obtained easily and with low costs) represents an important parameter to be considered in the evaluation of the renal function impairment, with the same probability of other more sophisticated and complex parameters.
