Corticosteroid use and its association with microalbuminuria in the adult population

Background. Corticosteroids exhibit a wide range of adverse effects, among which are a number of cardiovascular effects. Microalbuminuria shows a strong correlation with these cardiovascular effects and is an indicator for cardiovascular risk. We now investigate whether use of corticosteroids, either systemic or nonsystemic, is associated with microalbuminuria.

Methods. We used the data of 7010 subjects of an on-going population based study, focussed on the impact of microalbuminuria (PREVEND). Microalbuminuria was defined as urinary albumin excretion of 30–300 mg/24 h, measured as the mean of two 24-h urine collections. Corticosteroid use was measured in the year preceding the albumin measurement using community pharmacy data

Results. After adjusting for age and sex, the odds ratio (OR) for having microalbuminuria was slightly elevated (1.21; 95% CI 1.03–1.41; N=1798) for corticosteroid users. The ORs were lower for subjects using only systemic corticosteroids (1.07; 95% CI 0.67–1.72; N=146), or only local corticosteroids (1.11; 95% CI 0.93–1.32; N=1442). However, the OR for subjects using both systemic and local corticosteroids was raised (1.99; 95% CI 1.42–2.77; N=210).

Conclusion. Corticosteroid use, and especially use of both systemic and local corticosteroids is associated with microalbuminuria. Based on this investigation we cannot say if this is due to adverse effects of corticosteroids themselves, or effects of the underlying disease.