Takeaway
- This meta-analysis suggests that proteinuria is a strong and independent risk factor for the development of stroke.
Why this matters
- Findings suggest that proteinuria could be routinely screened for when cardiovascular risk profiling and may need to be incorporated in risk prediction scores
Study design
- Meta-analysis included 38 studies (n=1,735,390) after a search across MEDLINE and EMBASE databases.
- Funding: None disclosed.
Key results
- The presence of proteinuria was associated with an increased risk for stroke (relative risk [RR], 2.00; 95% CI, 1.63-2.46; P<.001) even after adjusting established cardiovascular risk factors (RR, 1.72; 95% CI, 1.51-1.95; P<.001).
- The risk remained significant after adjustment for:
- single baseline blood pressure measure (RR, 1.92; 95% CI, 1.39-2.66; P<.001),
- history or treated hypertension (RR, 1.76; 95% CI, 1.13-2.75; P=.013) and
- multiple blood pressure measurements over months to years (RR, 1.68; 95% CI, 1.33-2.14; P<.001).
- In the presence of a low estimated glomerular filtration rate, any level of proteinuria significantly increased the risk for stroke (RR, 2.23; 95% CI, 1.48-3.37; P<.01).
Limitations
- Heterogeneity between studies.
- Risk for bias.
References
References
