THE ROLE OF ALBUMINURIA AS A PREDICTOR OF CARDIOVASCULAR COMPLICATIONS

Albuminuria has traditionally been recognized as a marker of kidney damage; however, growing evidence suggests its significant role as a predictor of cardiovascular complications. This review aims to evaluate the predictive value of albuminuria, including low-level urinary albumin-to-creatinine ratio (UACR), in relation to cardiovascular outcomes. A comprehensive literature review was conducted using data from cohort studies, meta-analyses, and international guideline recommendations focusing on the association between albuminuria and cardiovascular disease (CVD). The findings demonstrate a consistent linear relationship between increasing albuminuria levels and the risk of myocardial infarction, stroke, heart failure, and cardiovascular mortality, even within the normoalbuminuric range (<30 mg/g). Quantitative analyses indicate that incorporating albuminuria into traditional cardiovascular risk models improves predictive accuracy, with incremental increases in C-statistic and hazard ratios across risk categories. Pathophysiological mechanisms underlying this association include systemic endothelial dysfunction, inflammation, and microvascular damage. Despite its strong prognostic significance, albuminuria screening remains underutilized in routine clinical practice. Early identification and targeted therapeutic interventions aimed at reducing albuminuria may contribute to improved cardiovascular and renal outcomes. The evidence supports the integration of albuminuria assessment into comprehensive cardiovascular risk stratification strategies.