Albuminuria is a prognostic factor for mortality and cardiovascular events, even at low levels. Changes in albumin excretion are associated with end-stage renal disease and hypertension (HTN) in cohorts including high-risk participants. We aimed to investigate the evolvement of albumin excretion in healthy individuals with normal kidney function and normoalbuminuria, and possible associations with HTN and metabolic outcomes. The study cohort consisted of 1967 healthy adults with normal kidney function (estimated glomerular filtration rate ≥ 90 mL/min/1.73 m²; urine albumin to creatinine ratio [ACR] < 30 mg/g). Delta ACR slope was calculated as ACR difference between two consecutive visits divided by the time interval. During a mean follow-up period of 93.8 months, mean delta ACR slope was 0.27 ± 3.29 mg/g/year and was higher in participants with age >40 years, obesity, a high waist circumference, higher baseline ACR, HTN, prediabetes, and metabolic syndrome. Delta ACR slopes in the upper quartile predicted diabetes (OR = 1.31, P = .027) and albuminuria (4.34, P < .001). Upper quartile of ACR slopes correlated with a higher risk for new-onset HTN (1.249, P = .031). Delta systolic and diastolic blood pressures were associated with ACR slopes in addition to age, body mass index, and baseline ACR. In conclusion, accelerated change in ACR correlates with HTN and diabetes in healthy individuals with normal kidney function and normoalbuminuria.

蛋白尿是即使在低水平时，死亡率和心血管事件的预后因素。白蛋白排泄的变化与包括高危参与者在内的人群的终末期肾脏疾病和高血压（HTN）相关。我们旨在调查正常肾脏功能和正常白蛋白尿的健康个体中白蛋白排泄的演变，以及与HTN和代谢结果的可能关联。该研究队列包括1967名肾功能正常的健康成人（估计肾小球滤过率≥90 mL / min / 1.73 m ²; 尿白蛋白与肌酐的比率[ACR] <30 mg / g）。Delta ACR斜率计算为两次连续访问之间的ACR差除以时间间隔。在93.8个月的平均随访期内，ACR的平均变化幅度为0.27±3.29 mg / g /年，年龄大于40岁，肥胖，腰围高，基线ACR，HTN，糖尿病前期，和代谢综合征。上四分位数预测的糖尿病（OR = 1.31，P  = .027）和蛋白尿（4.34，P  <.001）的Delta ACR斜率。ACR斜率的上四分位数与新发HTN的较高风险相关（1.249，P = .031）。除年龄，体重指数和基线ACR外，收缩期和舒张期血压也与ACR斜率相关。总之，在肾功能正常和白蛋白尿正常的健康个体中，ACR的加速变化与HTN和糖尿病相关。