Search Results (139)

Background/Objectives: The novel compound 221s (2,9), derived from danshensu and ACEI-active proline, exhibits antihypertensive effects (50/35 mmHg SBP/DBP reduction in SHRs) with potential cough mitigation. However, its excretion kinetics remain unstudied. This study investigates 221s (2,9) elimination in rats to bridge this knowledge gap. Methods: Excretion of unchanged 221s (2,9) was quantified in urine, feces, and bile of Sprague-Dawley rats after oral administration (30 mg/kg). Concentrations of unchanged 221s (2,9) in all matrices were quantified using developed UPLC-MS/MS that underwent methodological validation. Excretion amount, excretion velocity, and accumulative excretion rate of 221s (2,9) were calculated. Results: Urinary excretion exhibited rapid elimination kinetics, reaching peak cumulative excretion rates (138.81 ± 15.56 ng/h) at 8 h post-dosing and plateauing by 48 h (cumulative excretion: 1479.81 ± 155.7 ng). Fecal excretion displayed an accelerated elimination phase between 4 and 8 h (excretion rate: 7994.29 ± 953.75 ng/h), followed by a sustained slow-release phase, culminating in a cumulative output of 36,726.31 ± 5507 ng at 48 h. Biliary excretion was minimal and ceased entirely by 24 h. Notably, total recovery of unchanged drug across all matrices remained below 1% (urine: 0.020 ± 0.021%; feces: 0.73 ± 0.069%; bile: 0.00044 ± 0.00002%) at 72 h. Conclusions: This study provides the first definitive excretion data for 221s (2,9). Quantitative analysis via a validated UPLC-MS/MS method revealed that fecal excretion is the principal elimination pathway for unchanged 221s (2,9) in rats, with direct excretion of the parent compound accounting for <1% of the administered dose over 72 h. Future studies will employ extended pharmacokinetic monitoring and concurrent UPLC-MS/MS analysis of the parent drug and phase II conjugates to resolve the observed mass imbalance and elucidate contributions to total elimination. Full article

(1) Background: The urate-lowering effects of three iridoid glycosides, which are paederosidic acid, paederosidic acid methyl ester, and paederoside, isolated from Paederia foetida and the protection they provide against hyperuricemia-induced kidney injury were investigated in a rat model. (2) Methods: A hyperuricemia (HUA) rat model was established in Sprague-Dawley (SD) rats through intraperitoneal potassium oxonate (PO) and intragastrical adenine for 2 weeks. Subsequently, rats in the pharmaceutical intervention groups received corresponding drug treatments at a concentration of 40 mg/kg/day, maintained consistently for 7 days. (3) Results: The results showed that three compounds reduced serum urate (SU), creatinine (CRE), and blood urea nitrogen (BUN) levels and that the urinary excretion levels of uric acid, urine urea nitrogen, and creatinine increased. Furthermore, the administration of three iridoid glycosides enhanced renal filtration capacity, as demonstrated by the elevated 24 h creatinine clearance rate (CCR) and 24 h uric acid clearance rate (CUA); improved the fraction excretion of uric acid (FEUA); and attenuated renal damage. Finally, three iridoid glycosides promoted uric acid excretion in HUA rats by downregulating URAT1 and GLUT9 and upregulating ABCG2, OAT1, and OAT3. Moreover, the molecular docking results further corroborated the finding that the three compounds can bind to multiple sites of the uric acid transporter via hydrogen, P-π, and hydrophobic bonds. (4) Conclusions: The three iridoid glycosides were found to lower SU levels by increasing uric acid excretion. They are promising natural products for the prevention of HUA and HUA-induced kidney injury. Full article

Background: Blood pressure (BP) variability has been increasingly recognized as a predictor of cardiovascular and renal outcomes. However, the relevance of specific dynamic indices such as the maximum slope of systolic blood pressure (max SBP slope), derived through partial Fourier series modeling, in relation to early renal damage remains underexplored. Methods: A total of 389 patients with essential hypertension were enrolled and stratified according to the estimated glomerular filtration rate (eGFR) ≥ or <90 mL/min/1.73 m² and the presence of subclinical renal damage, defined by elevated urinary albumin excretion (AER) and/or reduced eGFR. All participants underwent clinical and biochemical evaluation, as well as 24-h ambulatory blood pressure monitoring (ABPM), including advanced hemodynamic analysis using Fourier-based modeling. Results: Patients with eGFR < 90 mL/min/1.73 m² were older and exhibited higher waist circumference, uricemia, albuminuria, and systolic BP values, including the elevated max SBP slope (12.8 vs. 10.8 mmHg/h, p = 0.028). Subclinical renal damage was associated with older age; male sex; smoking; and higher levels of uricemia, clinical, and ambulatory BP, and the max SBP slope (14.2 vs. 10.7 mmHg/h, p = 0.007). The max SBP slope positively correlated with AER (r = 0.215, p < 0.001) and inversely with eGFR (r = −0.153, p = 0.002). In multivariate linear regression, the max SBP slope remained independently associated with AER (β = 0.220, p < 0.001), along with mean 24-h SBP, male sex, and the day–night SBP percentage dip. Logistic regression confirmed these associations with subclinical renal damage (max SBP slope OR: 1.536; 95% CI: 1.241–2.004; p = 0.001). Conclusions: The max SBP slope, a dynamic index of BP derived via Fourier analysis, is independently associated with markers of subclinical renal damage in hypertensive patients. This suggests that incorporating such advanced metrics into ABPM evaluation may improve early risk stratification and help identify individuals at greater risk of renal impairment, even in the absence of overt kidney disease. Full article

The agriculture sector is responsible for the largest proportion of greenhouse gas emissions in Northern Ireland and mitigation strategies must be introduced if the industry is to achieve the ‘Net Zero’ targets set for 2050 by the United Kingdom government. Dairy farming is a source of nitrous oxide emissions, a potent greenhouse gas with 256 times the warming potential of carbon dioxide. One potential mitigation measure is the use of alternative forage species such as Ribwort Plantain (Plantago lanceolata). Evidence would suggest that plantain has the ability to improve nitrogen use efficiency (NUE), leading to reductions in overall nitrogenous emissions from grazing dairy systems via three pathways: reducing urinary nitrogen concentration leading to lower rates of nitrogen leaching from urine patches; improving nitrogen utilisation efficiency within the dairy cow so that a lesser proportion of dietary nitrogen is excreted via the urine; and through the action of root exudates producing biological nitrification inhibition in the soil and improving soil nitrogen retention. This review summarises the current evidence supporting plantain as an alternative forage to support animal performance and forage production whilst lowering the environmental footprint of grazing dairy systems in temperate climates. This review also highlights outstanding research questions which must be addressed for farmers to confidently introduce these alternative species into their grazing platforms. Full article

Chronic exposure to the pollutant cadmium (Cd) is inevitable for most people because it is present in nearly all food types. Concerningly, the risk of developing hypertension has been linked to dietary Cd exposure lower than 58 µg/day for a 70 kg person. The mechanisms involved are, however, unclear. Since the kidneys play an indispensable role in long-term blood pressure regulation, and they are also the main site of Cd accumulation and toxicity, a retrospective analysis was conducted to examine if kidney damage and malfunction, reflected by urinary β₂-microglobulin excretion (E_β2M), and the estimated glomerular filtration rate (eGFR), are related to Cd excretion (E_Cd) and blood pressure variation. Data were obtained from 689 Thai Nationals without diabetes or occupational exposure to Cd, of which 32.4% had hypertension and 7.3% had β₂-microglobulinuria, defined as an increase in the β₂M excretion rate ≥ 300 µg/g creatinine. Respective prevalence odds ratio (POR) and 95% confidence interval (CI) values for β₂-microglobulinuria and hypertension were 10.7 (1.36–83.4), p = 0.024 and 2.79 (1.60–4.87) p < 0.001, comparing the top quartile of E_Cd with the bottom quartile. Only in subjects with eGFR below 90 mL/min/1.73 m² did systolic blood pressure (SBP) and diastolic blood pressure (DBP) both increase linearly with E_β2M (respective β = 0.182 and 0.192 for SBP and DBP) after adjustment for age, body mass index, gender, and smoking. The present study confirms the significant impact of Cd on the risk of having hypertension, following GFR loss induced by Cd. A simple mediation model analysis for cause–effect inference has provided, for the first time, evidence that may link rising SBP and DBP in Cd-exposed people to a novel role of β₂M as a predictor of blood pressure variability. Full article

Volume kinetics is a pharmacokinetic method for analysis of the distribution and elimination of infusion fluids. The approach has primarily been used to improve the planning of fluid therapy during surgery but is also useful for answering physiological questions. The kinetics is based on 15–35 serial measurements of the blood hemoglobin concentration during and after the fluid is administered intravenously. Crystalloid fluid, such as isotonic saline and Ringer’s lactate, distributes between three compartments that are filled in succession depending on how much fluid is administered. The equilibration of fluid between these three compartments is governed by five rate constants. The compartments are the plasma (V_c), and a fast-exchange (V_t1) and a slow-exchange interstitial compartment (V_t2). The last compartment operates like an overflow reservoir and, if filled, markedly, prolongs the half-life of the fluid. By contrast, the volume of a colloid fluid distributes in a single compartment (V_c) from where the expansion is reduced by capillary leakage and urinary excretion. This review gives 15 examples of physiological or medical questions where volume kinetics has provided answers. These include why urine flow is low during general anesthesia, the inhibitory effects of anesthetics on lymphatic pumping, the influence of dopamine and phenylephrine on urine output, fluid maldistribution in pre-eclampsia, plasma volume oscillations, and issues related to the endothelial glycocalyx layer. Full article

Kidney function parameters including estimated glomerular filtration rate (eGFR) and urine albumin excretion are commonly used to diagnose chronic kidney disease (CKD). However, these parameters are relatively insensitive, limiting their utility for screening and early detection of kidney disease. Studies have suggested that urinary proteomic profiles differ by eGFR stage, offering potential insights into kidney disease pathogenesis alongside opportunities to increase the sensitivity of current testing strategies. In this study, we characterized and compared the urinary proteome across different eGFR stages in a Black African cohort from rural Mpumalanga Province, South Africa. We stratified 81 urine samples by eGFR stage (mL/min/1.73 m²): Stage G1 (eGFR ≥ 90; n = 36), Stage G2 (eGFR 60–89; n = 35), and Stage G3–G5 (eGFR < 60; n = 10). Urine proteomic analysis was performed using an Evosep One liquid chromatography system coupled to a Sciex 5600 TripleTOF in data-independent acquisition mode. Nonparametric multivariate analysis and receiver operating characteristic (ROC) curves were used to assess the performance of differentially abundant proteins (DAPs). Pathway analysis was performed on DAPs. Creatinine-based eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. In this study, thirty-eight urinary proteins were differentially abundant for eGFR Stages 3–5 when compared to Stages G1 (AUC = 0.95; CI: 0.86–1) and G2 (AUC = 0.84; CI: 0.64–0.98). Notably, only six urinary proteins (Cystatin M (CST6), glutathione hydrolase 6 (GGT6), sushi domain containing 2 (SUSD2), insulin-like growth factor binding protein 6 (IGFBP6), heat shock protein 90 beta family member 1 (HSP90B1), and mannosidase alpha class 1A member 1 (MAN1A1)) were differentially abundant when comparing Stage G1 and Stage G2 with a modest AUC = 0.81 (CI: 0.67–0.92). Pathway analysis indicated that DAPs were associated with haemostasis and fibrin clot formation. In a rural cohort from South Africa, the urinary proteome differed by eGFR stage, and we identified six differentially abundant proteins which, in combination, could help to differentiate earlier eGFR stages with higher predictive accuracy than the currently available tests. Full article

Obesity has emerged as a global epidemic, creating an increased burden of weight-related diseases and straining healthcare systems worldwide. While the fundamental principle of energy balance—caloric intake versus expenditure—remains central to weight regulation, real-world outcomes often deviate from simplistic predictions due to a multitude of physiological and environmental factors. Genetic predispositions, variations in basal metabolic rates, adaptive thermogenesis, physical activity, and nutrient losses via fecal and urinary excretion contribute to interindividual differences in energy homeostasis. Additionally, factors such as meal timing, macronutrient composition, gut microbiota dynamics, and diet-induced thermogenesis (DIT) further modulate energy utilization and metabolic efficiency. This Perspective explores key physiological determinants of the energy balance, while also highlighting the clinical significance of thrifty versus spendthrifty metabolic phenotypes. Key strategies for individualized weight management include precision calorimetry, circadian-aligned meal timing, the use of protein- and whole food diets to enhance DIT, and increases in non-exercise activity, as well as mild cold exposure and the use of thermogenic agents (e.g., capsaicin-like compounds) to stimulate brown adipose tissue activity. A comprehensive, personalized approach to obesity management that moves beyond restrictive caloric models is essential to achieving sustainable weight control and improving long-term metabolic health. Integrating these multifactorial insights into clinical practice will enhance obesity treatment strategies, fostering more effective and enduring interventions. Full article

Background/Objectives: Post-translationally modified peptide fragments of fetuin-A (FetA) were identified as a potential biomarker of diabetic kidney disease (DKD). An independent association between urinary FetA-derived peptide levels (uPTM3-FetA) and DKD progression in patients with type 2 diabetes (T2D) was evidenced. This study aimed to explore uPTM3-FetA excretion and its associations with insulin resistance, inflammatory and metabolic biomarkers in patients with type 1 diabetes (T1D), and the normal albuminuria and estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73 m². Methods: uPTM3-FetA levels in aliquots of 24 h urine specimens, routine laboratory renal, metabolic and inflammatory tests, adipokines (leptin, adiponectin, resistin), and insulin resistance, assessed as the estimated glucose disposal rate (eGDR), were measured in a cohort of 169 adult T1D patients. To evaluate the changes in early renal dysfunction, the cohort was divided according to the median eGFR. Above- and below-median-eGFR groups were considered as having normal and declining kidney function, respectively. Results: The median (IQR) uPTM3-FetA level was 11.7 (8.43–16.65 µg/24 h), with no significant difference between males and females, as well as normal and declining kidney function patients. However, a sex-specific analysis revealed a significantly higher uPTM3-FetA excretion in male T1D patients with lower eGFRs, when compared to those with higher eGFRs, whereas no such difference was observed in female patients. BMI, hs-CRP, resistin and HDL-cholesterol were identified as independent predictors of uPTM3-FetA excretion. Conclusions: Our results implicate the potential role of uPTM3-FetA in the detection of an early renal dysfunction in male patients with T1DM and pinpoint the importance of a sex-specific approach in diabetes diagnostics and research. Full article

Background: Excessive accumulation of glomerular extracellular matrix (ECM) is a key factor in the development and progression of diabetic nephropathy (DN). As kidney dysfunction has been reported in normoalbuminuric patients, identifying novel diagnostic and prognostic markers is essential for the prevention and treatment of DN. Methods: Urinary excretion of neutrophil gelatinase-associated lipocalin (NGAL) and ECM-related glycoproteins, i.e., fibronectin (FN) and laminin (LN), was measured in obese patients with newly diagnosed type 2 diabetes mellitus (T2DM) before and after 6 months of metformin therapy. Results: Baseline NGAL (1.27 (0.80–2.36) ng/mg Cr), FN (11.19 (5.31–21.56) ng/mg Cr) and LN (123.17 (54.56–419.28) pg/mg Cr) levels did not significantly differ between T2DM patients and controls (1.95 (1.09–2.97) ng/mg Cr, 11.94 (7.78–18.01) ng/mg Cr and 157.85 (83.75–326.40) pg/mg Cr, respectively). In multivariate regression analysis, the body mass index was identified as the only significant predictor influencing urinary NGAL and FN levels at baseline, with β = 0.249, p = 0.005 and β = 1.068, p = 0.010, respectively. Metformin treatment significantly increased urinary levels of both ECM proteins, i.e., FN (18.48 (11.64–32.46) ng/mg Cr) and LN (179.51 (106.22–414.68) pg/mg Cr), without any effect on NGAL levels (1.44 (0.81–2.72) ng/mg Cr). FN and LN were positively associated with NGAL both before (r = 0.709 and r = 0.646, both p < 0.001, respectively) and after (r = 0.594 and r = 0.479, both p < 0.001, respectively) therapy. No correlations were found between NGAL, FN, LN, and albuminuria. However, NGAL was positively correlated with the albumin/creatinine ratio (ACR) both before (r = 0.323, p < 0.05) and after (r = 0.287, p < 0.05) therapy, and negatively with estimated glomerular filtration rate (eGFR) in pre-treatment diabetics (r = −0.290, p < 0.05). FN and LN were also correlated with ACR (r = 0.384, p < 0.01 and r = 0.470, p < 0.001), although the association for LN was limited to untreated patients (r = 0.422, p < 0.01). Conclusions: Our results suggest that metformin has a beneficial effect on ECM turnover with a significant increase in urinary excretion of non-collagenous markers of glomerular injury, i.e., FN and LN. Additionally, ECM-related markers may serve as useful tools for monitoring early renal injury in obese diabetic patients. Full article

Background/Objectives: Considering the physiological analogies between the eye and the kidney, this study aimed to investigate the potential relationship between retinal vascular density, assessed using Optical Coherence Tomography Angiography (OCT-A), and the renal resistive index (RRI) in patients with arterial hypertension. Methods: A total of 82 hypertensive patients (mean age 48 ± 13) were enrolled in the study. Participants underwent routine biochemical evaluations, office-based blood pressure measurement, 24 h ambulatory blood pressure monitoring, OCT-A imaging, and renal Doppler ultrasound examinations. Results: The mean RRI in the study population was 0.616 ± 0.06. Participants were divided into two groups based on the 75th percentile threshold of the RRI distribution (0.66, 95% CI 0.64–0.68). The group with RRI > 75th percentile, which appeared to have a higher number of smokers, exhibited significantly higher mean triglyceride and urinary albumin excretion (UAE) levels and a significantly reduced estimated glomerular filtration rate (eGFR) as compared to the group with RRI < 75th percentile. Among the hemodynamic parameters, 24 h pulse pressure (PP), daytime and nighttime PP, and nighttime systolic blood pressure (SBP) were significantly higher in the group with RRI > 75th percentile. Regarding retinal vascular density indices, the only significant difference was observed in the deep foveal vascular plexus, which displayed a reduced density in the group with RRI > 75th percentile. Logistic regression analysis revealed that RRI > 75th percentile was independently associated with increased nighttime mean pulse pressure (OR = 1.13, 95% CI: 1.049–1.221, p = 0.0014) and reduced deep foveal vascular density (OR = −0.5026, 95% CI: 1.0493–1.2211, p = 0.0044). Conclusions: Our findings demonstrate that ocular microvascular alterations are associated with RRI, a marker with a well-established prognostic value for renal disease progression and systemic macrovascular dysfunction. These results further substantiate the close relationship between renal and ocular microcirculation. Full article

Introduction: An increased renal resistive index (RRI) and proteinuria can predict an estimated glomerular filtration rate (eGFR) decline in patients with chronic kidney disease (CKD) of various causes. This study hypothesized that the RRI and proteinuria interact to determine disease progression in patients with CKDs of unknown origin. Patients and Methods: One hundred and fifty six patients (age 76.0 ± 8.1 years, 63.5% males) were analyzed for anthropometric, kidney morphology, blood pressure, 24 h urinary protein excretion, and RRI. The CKD-EPI equation was used to calculate the eGFR at baseline and after a two-year follow-up. Patients with an elevated (≥0.80) or normal (<0.80) RRI and significant (≥150 mg/day) or physiological (<150 mg/day) proteinuria were evaluated for the likelihood of at least a 30% drop in the eGFR or the onset of end-stage kidney disease (endpoint). Results: Hypertension and diabetes were the predominant cardiovascular risk factors (90.4%). Fifty patients (32%) met the endpoint. Elevated RRIs (odds ratio, OR, 4.28; 95% confidence interval, CI, 1.82–10.6; p = 0.001) and significant proteinuria (OR 3.59, 95% CI 1.59–8.48, p = 0.003) were independent predictors of the endpoint in a multivariate logistic model. Patients with an elevated RRI and significant proteinuria were more likely to meet the endpoint (R1P1: 65.2%) compared to those with only proteinuria (R0P1: 39.5%, p = 0.043) or both normal factors (R0P0: 10.9%, p < 0.001) but not to those with only an elevated RRI (R1P0: 42.3%, p = 0.094). Continuous RRIs (partial correlation r = −0.245, p < 0.001) and 24 h urinary protein excretion (partial r = −0.226, p = 0.003) were inversely and independently correlated with eGFR% change. R1P1 showed a higher eGFR% reduction (−38.0% ± 20.4%) compared to R0P1 (−25.3% ± 19.0%, p = 0.043) and R0P0 (−8.8% ± 25.1%, p < 0.001) but not to R1P0 (−29.6% ± 21.0%, p = 0.192). Conclusions: An increased RRI and proteinuria were independent predictors of disease progression. When interaction was considered, the negative effect of an elevated RRI on CKD progression was evident in both proteinuric and non-proteinuric patients, whereas the negative effect of proteinuria on disease progression was only significant in patients with no elevated RRIs. Full article

Introduction: Korea has higher levels of heavy metals compared to other countries, raising the need to study the health impacts on vulnerable populations. This study examined the effects of heavy metal exposure—lead, mercury, and cadmium—on kidney function in residents of environmentally vulnerable areas compared to the general population in Korea. Methods: Epidemiological studies in vulnerable areas and official data from the Fourth Korean National Environmental Health Survey were analyzed to assess blood levels of lead and mercury and urinary cadmium. An integrated heavy metal concentration was calculated, combining the levels of these metals. Kidney function was evaluated using the estimated glomerular filtration rate (eGFR), classified into normal, mildly reduced, and impaired. Correlation and logistic regression analyses were used to examine relationships between heavy metal levels and eGFR. Results: The integrated heavy metal concentration in vulnerable areas was higher than in the general population. In the general population, increased heavy metal levels were associated with a decrease in eGFR, whereas in vulnerable areas, eGFR increased with higher heavy metal levels. In the general population, a rise in urinary cadmium increased the risk of eGFR decline by 19.9%, while in vulnerable areas, higher urinary cadmium reduced this risk by 23.3%. Conclusions: Contrasting relationships between heavy metal exposure and eGFR in vulnerable areas versus the general population may be due to long-term exposure and reduced renal excretion. This study underscores the need for continued monitoring in vulnerable areas, and future research should identify eGFR thresholds that correlate with heavy metal level shifts. Full article

Background: Clinical findings have shown a negative correlation between the severity of depressive symptoms and serum uric acid levels in men, yet the role of metabolic regulation in the pathophysiology of depression remains largely unknown. Methods: In this study, we utilized an acute restraint-stress-induced male rat model of depression to investigate biochemical changes through NMR-based metabolomics combined with serum biochemical analysis. Additionally, we employed qPCR, immunoblotting, and enzyme activity assays to assess the expression and activity of xanthine oxidoreductase, the rate-limiting enzyme in uric acid production. Results: Our findings indicate the following: (1) restraint stress is a valid method for inducing a depressive phenotype in rats; (2) depressive rats exhibit decreased NAD(P) levels in the liver and increased nicotinamide N-oxide and nicotinate levels in urine, accompanied by decreased levels of uric acid, allantoin, and allantoic acid in serum or tissues; (3) xanthine dehydrogenase activity is diminished in depressive rats without corresponding changes in gene or protein expression. Conclusion: The increased urinary excretion of NAD(P) precursors results in reduced hepatic NAD(P) levels, thereby suppressing NAD-dependent xanthine dehydrogenase activity and diminishing the production of uric acid and its downstream metabolites (allantoin and allantoic acid). Full article

Background: Albuminuria and albumin excretion rate (AER) are important risk factors for chronic kidney disease (CKD) development. Despite the extensive evidence of the influence of sodium and potassium on cardiovascular health, the existing evidence regarding their impact on albuminuria and kidney disease is limited and inconsistent. Our study aimed to assess the correlation between urinary sodium and potassium excretion, and the sodium-to-potassium ratio (Na/K ratio) with impaired kidney function, particularly the AER and albuminuria. Materials and Methods: Data were collected from the Lithuanian NATRIJOD study. A total of 826 single 24-h urine samples from individuals aged 18 to 69 were collected and analyzed for their sodium and potassium levels, Na/K ratio, and AER. Albuminuria was defined as an AER exceeding 30 mg/24 h. Results: The participant mean age was 47.2 ± 12.1 years; 48.5% of the participants were male. The prevalence of albuminuria was 3%. Correlation analysis revealed a positive correlation between AER and urinary sodium excretion (r_s = 0.21; p < 0.001) and urinary potassium excretion (r_s = 0.28; p < 0.001). In univariate linear regression analysis, sodium and potassium excretion and the Na/K ratio were significant AER predictors with β coefficients of 0.028 (95% CI: 0.015; 0.041; p < 0.001), 0.040 (95% CI: 0.003; 0.077; p = 0.035), and 1.234 (95% CI: 0.210; 2.259; p = 0.018), respectively. In the multivariable model, only urinary sodium excretion remained significant, with a β coefficient of 0.028 (95% CI: 0.016; 0.041). Potential albuminuria predictive factors identified via univariate logistic regression included urinary sodium excretion (OR 1.00; 95% CI: 1:00; 1.01) and the Na/K ratio (OR 1.53; 95% CI: 1.11; 2.05). However, these factors became statistically insignificant in the multivariate model. Conclusions: Urinary sodium and potassium excretion and the Na/K ratio are significantly associated with kidney damage, considering the assessed 24-h albumin excretion rate and presence of albuminuria content. Full article