METABOLIC SYNDROME AND MICROALBUMINURIA PREDICT RENAL OUTCOME IN NON DIABETIC PATIENTS WITH PRIMARY HYPERTENSION: THE MAGIC STUDY: 2D.03

Abstract

Objective: Metabolic syndrome has recently been shown to be a forerunner of chronic kidney disease. Microalbuminuria is associated with both metabolic syndrome and chronic kidney disease. This study aimed to prospectively investigate the relationship between microalbuminuria, metabolic syndrome and renal outcome in non diabetic patients with primary hypertension. Design and Method: A total of 790 hypertensive patients enrolled in the MAGIC study (Microalbuminuria: a Genoa investigation on complications) between 1993 and 1997 were included in the analysis. Renal outcome was defined as the first hospitalization with a diagnosis of chronic kidney disease. Results: At baseline, 146 (19%) and 60 (7.6%) patients met metabolic syndrome and microalbuminuria criteria, respectively. After a median follow-up of 11.6 years, renal end-point was reached in 15.8% of patients with metabolic syndrome and in 8.9% of those without it (P = 0.0087). The risk of renal events increased progressively starting from patients with neither metabolic syndrome nor microalbuminuria, to patients with only one of these abnormalities, and then to those with both. Significant interaction was observed between metabolic syndrome and microalbuminuria. Patients with concomitant occurrence of metabolic syndrome and microalbuminuria at baseline showed a greater than 5-fold risk of renal outcome as compared to patients with neither of these two risk factors. This risk became even higher when data were adjusted for potential confounders. Conclusions: Metabolic syndrome and microalbuminuria are independent and interactive predictors of renal outcome in non diabetic patients with primary hypertension.