PROTEINURIA is an established risk factor for cardiovascular events, but its prognostic value for sudden cardiac arrest (SCA) in young adults has not been fully explored. A recent study suggests that proteinuria may serve as an early indicator of cardiovascular risks, even in those without obvious pre-existing conditions. Researchers found that proteinuria is significantly linked to a higher risk of SCA in young adults, especially those with chronic kidney disease.
The study analysed data from 6,345,162 individuals (aged 20–39 years) who underwent health screening in South Korea between 2009 and 2012. The presence of proteinuria was assessed using the spot urine dipstick test, and participants were followed up until December 2020 (mean follow up of 9.4±1.2 years). The main outcome measured was the occurrence of SCA.
Among participants, 5,352 individuals (0.08%) experienced SCA during the follow-up period. The incidence of SCA was notably higher in those with proteinuria (n=182; incidence rate 0.19%) than those without (n=5170; incidence rate 0.09%). After adjusting for confounding factors, researchers observed that individuals with proteinuria had a 71% increased risk of SCA (adjusted hazard ratio [aHR] = 1.71; 95% CI: 1.47–1.99; p=0.001). Furthermore, participants were categorised by their urine dipstick test results into two groups: early stage proteinuria +1–2 (urine protein level 30–300 mg/dL) (aHR 1.61; 95% CI: 1.37–1.89; p=0.001) and later stage proteinuria +3–4 (urine protein level ≥300 mg/dL) (aHR 2.94; 95% CI: 1.96–4.40), suggesting that the greater the degree of proteinuria, the greater the risk of SCA. Additionally, in individuals with proteinuria and chronic kidney disease the risk of SCA was even greater (aHR 5.52; 95% CI: 3.80–8.03).
This study demonstrates that proteinuria is significantly associated with an increased risk of SCA in young adults, particularly in those with chronic kidney disease. However, the study is not without limitations. The authors note reliance on a single urine dipstick measurement rather than serial assessments is a potential limitation, as well as the lack of diversity in the study population. Further research is needed to determine whether these findings are applicable to other ethnic groups and ages.
Reference
Jeong JH et al. Proteinuria Is Associated With an Increased Risk of Sudden Cardiac Arrest in the Young Population. J Am Heart Assoc. 2025;DOI: 10.1161/JAHA.124.036077.
