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Prognostische waarde van (micro)albuminurie voor cardiovasculaire events
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The PREVEND Study
Acronym for:
Prevention of REnal and Vascular ENd-stage Disease Study
Since 1997
Groningen, The Netherlands
www.PREVEND.org
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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?
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Prevalence of micro-albuminuria - The general non-diabetic population -
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Albuminuria as predictor of CV mortality - The general population -
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MA predicts CV events in the general population - The Danish Monica Study -
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Albuminuria as determinant of CV events in hypertension with LVH
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Interplay between albuminuria and renal function in predicting outcome
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Albuminuria as predictor of ESRD
- 8 years of follow-up -
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Community based screening for MA - A predictor for eGFR deterioration? -
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Interplay between albuminuria and renal function in predicting outcome
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“Isolated microalbuminuria”
Baseline characteristics
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“Isolated microalbuminuria”
The effect of ACE inhibition
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RAS Intervention protects the heart
- Particularly in those with poor renal function -
PEACE Trial
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Efficacy screen / treat program preventing ESRD
- Yield depends on baseline eGFR and albuminuria -
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RAS Intervention protects the heart
- Particularly in those with micro-albuminuria -
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Does measuring albuminuria add to
present CV risk profiling scores?
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Does measuring albuminuria add to
present CV risk profiling scores?
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Does measuring albuminuria add to
present CV risk profiling scores?
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Title
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K/DOQI staging of chronic kidney disease - To facilitate renal AND CV risk stratification -
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LTA Nierfalen (2009, concept)
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LTA Nierfalen (2009, concept)
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KDIGO classification of CKD (2009, concept)
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KDIGO classification of CKD (2009, concept)
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Predictive value of albuminuria Does it matter which albuminuria measure is used?
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“Isolated microalbuminuria”
Cost-effectiveness of screening and ACEi
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LTA Nierfalen (2009, concept)
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Renoprotective treatment should be started early
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The course of renal function
Lessons to be learnt from the diabetic population?
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The value of mass screening for albuminuria
- Study selection procedure -
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Albuminuria only result of DM / HT?
High incidence of de novo CV risk factors
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Subjects with hypercholesterolemia and prior CVD
- Proteinuria and eGFR versus mortality and CVD -
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Effects of ACEi
- The “healthy” with micro-albuminuria -
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