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Low-grade albuminuria in pulmonary arterial hypertension

dc.contributor.authorNickel, Nils P.
dc.contributor.authorFessel, Joshua P.
dc.contributor.authorCogan, Joy D.
dc.contributor.authorHamid, Rizwam
dc.contributor.authorWest, James D.
dc.contributor.authorde Caestecker, Mark P.
dc.contributor.authorAustin, Eric D.
dc.identifier.citationNickel NP, de Jesus Perez VA, Zamanian RT, Fessel JP, Cogan JD, Hamid R, West JD, de Caestecker MP, Yang H, Austin ED. Low-grade albuminuria in pulmonary arterial hypertension. Pulm Circ. 2019 Apr-Jun;9(2):2045894018824564. doi: 10.1177/2045894018824564. PMID: 30632900; PMCID: PMC6557031.en_US
dc.description.abstractLow-grade albuminuria, determined by the urinary albumin to creatinine ratio, has been linked to systemic vascular dysfunction and is associated with cardiovascular mortality. Pulmonary arterial hypertension is related to mutations in the bone morphogenetic protein receptor type 2, pulmonary vascular dysfunction and is increasingly recognized as a systemic disease. In a total of 283 patients (two independent cohorts) diagnosed with pulmonary arterial hypertension, 18 unaffected BMPR2 mutation carriers and 68 healthy controls, spot urinary albumin to creatinine ratio and its relationship to demographic, functional, hemodynamic and outcome data were analyzed. Pulmonary arterial hypertension patients and unaffected BMPR2 mutation carriers had significantly elevated urinary albumin to creatinine ratios compared with healthy controls (P < 0.01; P = 0.04). In pulmonary arterial hypertension patients, the urinary albumin to creatinine ratio was associated with older age, lower six-minute walking distance, elevated levels of C-reactive protein and hemoglobin A1c, but there was no correlation between the urinary albumin to creatinine ratio and hemodynamic variables. Pulmonary arterial hypertension patients with a urinary albumin to creatinine ratio above 10 mu g/mg had significantly higher rates of poor outcome (P < 0.001). This study shows that low-grade albuminuria is prevalent in pulmonary arterial hypertension patients and is associated with poor outcome. This study shows that albuminuria in pulmonary arterial hypertension is associated with systemic inflammation and insulin resistance.en_US
dc.description.sponsorshipNHLBI NIH HHSUnited States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Heart Lung & Blood Institute (NHLBI) TT32 HL129970 R01 HL134802 R01 HL136748 P01 HL108800 K08 HL121174en_US
dc.rightsCreative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the CreativeCommons Attribution-NonCommercial 4.0 License ( whichpermits non-commercial use, reproduction and distribution of the work without further permission provided the originalwork is attributed as specified on the SAGE and Open Access pages (
dc.subjectpulmonary hypertension;en_US
dc.titleLow-grade albuminuria in pulmonary arterial hypertensionen_US

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