Cardiovasculaire Geneeskunde.nl

Prognostische waarde van (micro)albuminurie bij cardiovasculaire events

Slides (presentatie) - 18 sep. 2009

Prognostische waarde van (micro)albuminurie voor cardiovasculaire events

The PREVEND Study Acronym for: Prevention of REnal and Vascular ENd-stage Disease Study Since 1997 Groningen, The Netherlands www.PREVEND.org

Pivotal questions Kan de risico marker makkelijk, goedkoop en niet belastend worden gemeten? Voorspelt de risico marker CV uitkomst? Voorspelt de risicomarker CV uitkomst onafhankelijke van andere, “gevestigde” risicofactoren / -markers? Leidt interventie gebaseerd op de risicomarker tot risico reductie? Voegt bepaling van de risicomarker toe aan huidige CV risico profilering?

Prevalence of micro-albuminuria - The general non-diabetic population -

Albuminuria as predictor of CV mortality - The general population -

MA predicts CV events in the general population - The Danish Monica Study -

Albuminuria as determinant of CV events in hypertension with LVH

Interplay between albuminuria and renal function in predicting outcome

Albuminuria as predictor of ESRD - 8 years of follow-up -

Community based screening for MA - A predictor for eGFR deterioration? -

Interplay between albuminuria and renal function in predicting outcome

“Isolated microalbuminuria” Baseline characteristics

“Isolated microalbuminuria” The effect of ACE inhibition

RAS Intervention protects the heart - Particularly in those with poor renal function - PEACE Trial

Efficacy screen / treat program preventing ESRD - Yield depends on baseline eGFR and albuminuria -

RAS Intervention protects the heart - Particularly in those with micro-albuminuria -

Does measuring albuminuria add to present CV risk profiling scores?

Does measuring albuminuria add to present CV risk profiling scores?

Does measuring albuminuria add to present CV risk profiling scores?

Title

K/DOQI staging of chronic kidney disease - To facilitate renal AND CV risk stratification -

LTA Nierfalen (2009, concept)

LTA Nierfalen (2009, concept)

KDIGO classification of CKD (2009, concept)

KDIGO classification of CKD (2009, concept)

Predictive value of albuminuria Does it matter which albuminuria measure is used?

“Isolated microalbuminuria” Cost-effectiveness of screening and ACEi

LTA Nierfalen (2009, concept)

Renoprotective treatment should be started early

The course of renal function Lessons to be learnt from the diabetic population?

The value of mass screening for albuminuria - Study selection procedure -

Albuminuria only result of DM / HT? High incidence of de novo CV risk factors

Subjects with hypercholesterolemia and prior CVD - Proteinuria and eGFR versus mortality and CVD -

Effects of ACEi - The “healthy” with micro-albuminuria -

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