Study of correlation of presence of microalbuminuria to target organ damage in essential hypertension cases

Authors

  • Pragati Bhole Department of Medicine, Government Medical College and Hospital, Nagpur, Maharashtra, India
  • Archana Aher Department of Medicine, Government Medical College and Hospital, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20184764

Keywords:

Essential hypertension, Microalbuminuria, Target organ damage

Abstract

Background: Critical amount of urinary albumin excretion has long been reported to be one strong predictor of cardiovascular events in hypertensive patients. Very few studies have been conducted till now depicting correlation of microalbuminuria and target organ damage in patients with essential hypertension, except cardiovascular events. We evaluated the prevalence of microalbuminuria in patients with essential hypertension and its relationship with target organ damage.

Methods: Total 120 patients of essential hypertension were studied. Prevalence of urinary albumin excretion and its correlation to target organ damage (left ventricular hypertrophy, retinopathy and stroke) was analysed. Urinary albumin excretion was assessed by turbidimetry method and microalbuminuria was assessed by urine albumin to creatinine ratio.

Results: Microalbuminuria was found to be present in 57.7% patients. Target organ damage was observed in 62.5% (75) patients, out of which 78.66% patients had associated microalbuminuria (p <0.05). Amongst them, higher prevalence was observed in patients with longer duration and greater severity of hypertension, increased body mass index and dyslipidemia.

Conclusions: Microalbuminuria assessment in hypertensive patients is an important test for the evaluation of target organ damage. Optimal management of hypertension, weight control, and maintenance of normal lipid levels leads to decreased risk of microalbuminuria. 

References

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 Dec 15;380(9859):2224-60.

Reddy KS, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. Lancet. 2005 Nov 12;366(9498):1744-9.

Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertension. 2014 Jun;32(6):1170-7.

Tagle R, Acevedo M, Vidt DG. Microalbuminuria: is it a valid predictor of cardiovascular risk?. Cleveland Clin J Med. 2003 Mar;70(3):255-61.

Bigazzi R, Bianchi S, Campese VM, Baldari G. Prevalence of microalbuminuria in a large population of patients with mild to moderate essential hypertension. Nephron. 1992;61(1):94-7.

Agrawal B, Berger A, Wolf K, Luft FC. Microalbuminuria screening by reagent strip predicts cardiovascular risk in hypertension. J Hypertension. 1996 Feb;14(2):223-8.

Yuyan MF, Khaw KT, Welch A, Bingham S, Day NE, Wareham NJ. A prospective study of microalbuminuria and incident CHD and its prognostic significance in a British population: The Epic-Norfolk Study. Am J Epidemiol. 2004 Feb:1:159(3):284-93.

Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2003- Guidelines for the prevention and management of Diabetes in Canada. Can J Diabetes 2003;27(suppl 2):S66-71.

Keane WF, Eknoyan G. Proteinuria, albuminuria, risk, assessment, detection, elimination (PARADE): a position paper of the National Kidney Foundation. Am J Kidney Dis. 1999 May 1;33(5):1004-10.

American Diabetes Association: Clinical Practice Recommendations 2001. Diabetes Care 2001; 24(Suppl 1):S69-72.

Andrew S, Levey MD, Joseph CE. National Kidney Foundation Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification. Ann Internal Med. 2003 July; 139(2):137-147.

Pontremoli R, Sofia A, Ravera M, Nicolella C, Viazzi F, Tirotta A, et al. Prevalence and clinical correlates of microalbuminuria in essential hypertension: the MAGIC study. Hypertension. 1997 Nov 1;30(5):1135-43.

Hitha B, Pappachan JM, Pillai HB, Sujathan P, Ramakrishna CD, Jayaprakash K, et al. Microalbuminuria in patients with essential hypertension and its relationship to target organ damage: an Indian experience. Saudi J Kidney Dis Transplantation. 2008 May 1;19(3):411-9.

Leoncini G, Sacchi G, Ravera M, Viazzi F, Ratto E, Vettoretti S, et al. Microalbuminuria is an integrated marker of subclinical organ damage in primary hypertension. J Human Hypertension. 2002 Jun;16(6):399-404.

Plavnik FL, Silva M, Kohlmann N. Relationship between microalbuminuria among elderly hypertensive patients: a cross sectional study from a teaching hospital from south India. Int Urol Nephrol. 2009;41(1):137-43.

Mogensen CE. Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. New Eng J Med. 1984 Feb 9;310(6):356-60.

Deckert T, Kofoed-Enevoldsen A, Nørgaard K, Borch-Johnsen K, Feldt-Rasmussen B, Jensen T. Microalbuminuria: implications for micro-and macrovascular disease. Diabetes Care. 1992 Sep 1;15(9):1181-91.

Palatini P, Graniero GR, Canali C, Santonastaso M, Mos L, Piccolo D, et al. Relationship between albumin excretion rate, ambulatory blood pressure and left ventricular hypertrophy in mild hypertension. J Hypertension. 1995 Dec;13(12 Pt 2):1796-800.

Hebert LA, Spetie DN, Keane WF. The urgent call of albuminuria/proteinuria: heeding its significance in early detection of kidney disease. Postgrad Med. 2001 Oct 1;110(4):79-96.

Cirillo M, Senigalliesi L, Laurenzi M, Alfieri R, Stamler J, Stamler R, et al. Microalbuminuria in nondiabetic adults: relation of blood pressure, body mass index, plasma cholesterol levels, and smoking: The Gubbio Population Study. Arch Internal Med. 1998 Sep 28;158(17):1933-9.

Palatini P. Microalbuminuria in hypertension. Curr Hypertens Resp. 2003 Jun;5(3):208-14.

Downloads

Published

2018-11-22

Issue

Section

Original Research Articles