| Background: Chronic kidney disease (CKD) is a significant global health concern with a rising prevalence and substantial
impact on healthcare systems. While CKD is often viewed as a progressive condition leading to end-stage renal disease
(ESRD), emerging evidence suggests that CKD regression is possible, particularly in relation to albuminuria levels.
Objective: This study aimed to explore the association between albuminuria and CKD regression in adults newly diagnosed
with moderate to severe CKD (stages G3b-G4). Methods: A retrospective cohort study was conducted at Katuri Medical
College and Hospital, Guntur, India, from July 1, 2020, to July 10, 2021. The study included 120 patients stratified into
four albuminuria categories based on albumin-to-creatinine ratio (ACR): A1 (<3 mg/mmol), A2 (3–29 mg/mmol), A3<60
(30–59 mg/mmol), and A3?60 (?60 mg/mmol). Key outcomes included CKD regression, progression, and mortality,
analyzed using cumulative incidence functions and Cox regression models. Results: Patients in the highest albuminuria
group (A3?60) were older (median age 82 years) and exhibited the highest mortality (17%) and comorbidity burden, while
those in lower albuminuria groups demonstrated better kidney function (eGFR) and lower mortality. Statin and ACEI/ARB
use were most prevalent in the higher albuminuria categories. CKD regression was inversely associated with albuminuria
severity. Conclusions: Albuminuria is a critical prognostic marker for CKD outcomes, influencing the likelihood of
regression and progression. Routine assessment of albuminuria should be integrated into risk stratification frameworks to
guide individualized treatment strategies. Early interventions targeting moderate albuminuria may optimize patient
outcomes.ddd |
