High Prevalence Of Microalbuminuria Research Articles

MICROALBUMINURIA IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS AND ITS CORRELATION WITH LEFT VENTRICULAR HYPERTROPHY”

Background: One of the most important factors in the development of cardiovascular diseases worldwide is Hypertension. A reliable indicator and a diagnostic modality in early stage of renal diseases and predictor of atrial hypertension (AH) progression is microalbminurea (MAU) which is also an independent risk factor of cardiovascular mortality and death.
 Objective: To determine the prevalence of microalbuminuria and left vertricular hypertrophy and assess correlation between micro albuminuria and LVH among newly diagnosed hypertensive patients.
 Methods: A cross sectional study conducted in Medical Unit IV, Jinnah Hospial Lahore from January to June, 2022. About 146 adults newly diagnosed hypertensive patients were included for study. Blood pressure was measured using sphygmomanometer with standard cuff in sitting position, with two measurements were made at least 5 min apart. Microalbuminuria was defined as albumin excretion 30 to 300 mg/dl in a spot urine sample report. Left ventricular hypertrophy (LVH) is defined as presence of concentric hypertrophy or diastolic dysfunction determined on Trans Thoracic ECHO by a cardiologist. Data was entered in SPSS Ver: 25.0 for data analysis and graphical presentation. For quantitative variables like age, ACR; mean and standard deviation was calculated. Prevalence and correlation of MAU and LVH in newly diagnosed hypertensive patients was using Spearmen’s Rank Correlation Analysis. Chi-square test was performed to compare MAU and LVH. P-value of < 0.05 was considered statistically significant. 
 Results: 146 subjects those fulfilling the inclusion criteria were admitted. Mean age was 48.281 + 24.865. 72.6% were male in our study. 30.8% of patients had LVH and microbuminurea was present in 47.5% of subject. About 28.6% of patient with LVH had MAU. (p=.030). There was a positive correlation between LVH and MAU. (r=0.135, P =.002).
 Conclusions: Our study concludes a high prevalence of micro albuminuria and LVH in newly diagnosed hypertensive. There is positive correlation between micro albuminuria and LVH and can be predictor of cardiovascular morbidity and mortality.

The Prevalence of Microalbuminuria in Patients with Hypertension and Acute Ischemic Stroke

Objective: The purpose of this study was to ascertain the prevalence of microalbuminuria in hypertensive individuals who had recently suffered from an acute ischemic stroke. Study Design: Cross-sectional study Place and Duration: Department of Physiology, Sheikh Zayed Medical College, Rahim Yar Khan in the duration from July, 2022 to December, 2022. Methods: This study comprised 148 hypertension individuals of either sex who had suffered an ischemic stroke. Participants' full demographic information, including age, sex, BMI, and comorbidities, was recorded after obtaining informed written consent. Microalbuminuria was detected in a urine sample collected over the course of 24 hours using the Pyrogallol Red assay. Microalbuminuria was defined as a daily urinary albumin content of 30-300 mg. Association of Microalbuminuria was determined among all cases. SPSS 22.0 was used to analyze all data. Results: Among 148 cases, 87 (58.8%) were males and 61 (41.2%) were females. Patients mean age was 57.6±14.82 years and had mean BMI 25.9±7.48 kg/m2. Mean duration of HTN was 3.19±5.28 years. History of ischemic stroke was found in 14 (9.5%) cases, and family history of myocardial infarction found in 23 (15.5%) cases. Comorbidities were DM, CAD, Congestive heart failure, Atrial fibrillation and peripheral artery disease. We found Microalbuminuria in 68 (45.9%) cases. In 68 cases of microalbuminuria 38 cases had age >50 years, 19 cases were aged between 36-50 years and 11 cases were aged between 18-35 years. Conclusion: The high prevalence of microalbuminuria in hypertension patients with acute ischemic stroke led us to the conclusion that this marker can be used to reliably identify hypertensive individuals at high risk for ischemic stroke at a low cost. Keywords: Hypertension, Albuminuria, Ischemic stroke, Diabetes mellitus

Prevalence of Microalbuminuria among Diabetic Patients Attending Federal Medical Centre Gusau, Nigeria

Microalbuminuria is persistent albumin excretion between 30 and 300 mg/day. In patients with diabetes, it is usually indicative of diabetic nephropathy which is the most common cause of end-stage renal disease; it is also associated with cardiovascular disease. The main objective was to determine the prevalence of microalbuminuria and its association with glycemic control, blood pressure, and duration of diabetes in type-1 and type-2 diabetic patients attending Federal Medical Center Gusau, Nigeria. This study evaluated the level of microalbuminuria among 150 diabetic patients and 50 control subjects. The urinary albumin concentration was measured by immunoturbidimetric assay. From both the control and diabetic subjects, fasting blood sugar was estimated and blood pressure was measured with an automated manometer. Prevalence of microalbuminuria (MAL) according to demographic, the incidence of variables was detected in 12 males 28 females, and < 40 years of age 10 and > 40 years of age 31. The Mean of Fasting Blood Glucose (FBG) was slightly higher in patients with Non-insulin Dependent Diabetes Mellitus (NIDDM) when compared to IDDM patients. There was no significant (p>0.05) difference between males and females, within the group regarding age, blood pressure, and glycemic status. However, there is a statistically significant difference (p>0.05) in FBG and MAL between the patients and the control. The results suggest that there is a high prevalence of microalbuminuria in patients attending Federal Medical Center Gusau which is an independent risk factor for renal and cardiovascular diseases.

Microalbuminuria and its association with adverse pregnancy outcome in a tertiary health centre in Nigeria.

Adverse pregnancy outcomes occur more commonly in developing countries and are still prevalent in our sub-region. Microalbuminuria is a marker of endothelial dysfunction and has been proposed as an aetiological factor in the development of some adverse pregnancy outcomes such as pre-eclampsia, intrauterine growth restriction (IUGR) and pre-term labour. The aim is to determine the prevalence of microalbuminuria and its association with adverse pregnancy outcomes. This was a prospective cross-sectional study with follow-up amongst women in early pregnancy presenting at Usmanu Danfodiyo University Teaching Hospital, Sokoto. Three hundred and thirty women with singleton pregnancy at gestational age <20 weeks, blood pressure <140/90 mmHg, normal fasting blood sugar and normal renal function were recruited. Those with a history of hypertension, diabetes mellitus, chronic kidney disease, sickle cell anaemia were excluded, multiple pregnancies, urinary tract infection or positive dipstick proteinuria at first contact were excluded. They were recruited consecutively and a structured interviewer-administered questionnaire was completed. Single-spot urine analysis for albumin was performed. The women were followed up to the time of delivery and the puerperium and any adverse outcome were documented. The prevalence of microalbuminuria was 58.4%. The maternal and foetal adverse outcomes such as hypertensive disorders of pregnancy, pre-mature rupture of membrane, IUGR, preterm birth and stillbirth occurred more amongst the women with microalbuminuria. However, there was no statistically significant association between microalbuminuria and having these adverse outcomes (P > 0.05). There was a high prevalence of microalbuminuria amongst healthy pregnant women and pregnancy complications occurred more frequently in women with microalbuminuria than in those without. However, this association was not sufficient to predict adverse outcomes in pregnancy.

Association of microalbuminuria with serum lipids and inflammatory markers in an adult population in the Dikgale Health and Demographic Surveillance System site, South Africa.

There is evidence that microalbuminuria (urinary albumin excretion) is an early sign of vascular damage and an established risk factor for cardiovascular morbidity and mortality. This study investigated the magnitude of microalbuminuria and its association with serum lipids and inflammatory markers among a rural black population residing in the Dikgale Health and Demographic Surveillance System site, South Africa. Data were collected from 602 presumably healthy participants (225 men and 377 women) aged ≥ 18 years. Biochemical data collection included serum lipids, glucose, insulin, high-sensitivity C-reactive protein (hs-CRP), urine albumin and creatinine. Anthropometry and blood pressure were also measured. Microalbuminuria was diagnosed with an albumin-creatinine ratio of ≥ 2.5 mg/mmol in men and ≥ 3.5 mg/mmol in women. Data were analysed using SPSS version 22.0. The mean age of participants was 48.63 ± 20.89 years. High percentages of microalbuminaria (35.7%), high levels of interleukin 6 (17.8%), hs-CRP (32.9%), triglycerides (TG) (26.1%), low-density lipoprotein cholesterol (52.2%) and total cholesterol (32.0%), and low levels of high-density lipoprotein cholesterol (29.1%) were observed in the population. Increased glucose levels (32.8%), insulin resistance (27.6%), hypertension (45.8%), overweight (26.8%) and obesity (25.4%) were also prevalent. Microalbuminuria was associated with high hs-CRP and TG levels in the men (adjusted odds ratios = 9.434, 95% confidence interval: 1.753 - 50.778, p = 0.01). High prevalence of microalbuminuria, hypertension, insulin resistance, overweight and obesity, as well as abnormal levels of serum lipids and inflammatory markers were observed in the population. Microalbuminuria was associated with high hs-CRP and TG levels among men.

Etiology of Persistent Microalbuminuria in Nigeria (P_MICRO study): protocol and study design

BackgroundMicroalbuminuria is an independent risk factor for cardiovascular and kidney disease and a predictor of end organ damage, both in the general population and in persons with HIV (PWH). Microalbuminuria is also an important risk factor for mortality in PWH treated with antiretroviral therapy (ART). In the ongoing Renal Risk Reduction (R3) study in Nigeria, we identified a high prevalence of microalbuminuria confirmed by two measurements 4–8 weeks apart in ART-experienced, virologically suppressed PWH. Although Stage 1 or 2 hypertension and exposure to potentially nephrotoxic antiretroviral medications were common in R3 participants, other traditional risk factors for albuminuria and kidney disease, including diabetes, APOL1 high-risk genotype, and smoking were rare. Co-infection with endemic pathogens may also be significant contributors to albuminuria, but co-infections were not evaluated in the R3 study population.MethodsIn Aim 1, we will cross-sectionally compare the prevalence of albuminuria and established kidney disease risk factors in a cohort of PWH to age- and sex-matched HIV-negative adults presenting for routine care at the Aminu Kano Teaching Hospital in Kano, Nigeria. We will leverage stored specimens from 2500 R3 participants and enroll an additional 500 PLWH recently initiated on ART (≤ 24 months) and 750 age- and sex-matched HIV-negative adults to determine the contribution of HIV, hypertension, and other comorbid medical conditions to prevalent albuminuria. In Aim 2, we will follow a cohort of 1000 HIV-positive, ART-treated and 500 HIV-negative normoalbuminuric adults for 30 months to evaluate the incidence and predictors of albuminuria.DiscussionThe findings from this study will support the development of interventions to prevent or address microalbuminuria in PWH to reduce kidney and cardiovascular morbidity and mortality. Such interventions might include more intensive monitoring and treatment of traditional risk factors, the provision of renin-angiotensin aldosterone system or sodium-glucose cotransporter-2 inhibitors, consideration of changes in ART regimen, and screening and treatment for relevant co-infections.

Relationship Between Microalbuminuria and Risk Factors for Cardiovascular Diseases Among Secondary School Student in Ilorin, Nigeria

Introduction: Globally, cardiovascular diseases (CVDs) are the leading causes of deaths with more than half due to coronary heart disease linked with the development of atherosclerosis. Hypertension (HTN) and obesity are leading risk factors for atherosclerotic CVDs, presence of which is predicted by microalbuminuria (MA). We wanted to evaluate the relationship between microalbuminuria and risk factors for CVDs (obesity, overweight, pre-hypertension and hypertension) among secondary school students in Ilorin, North central Nigeria. Methods: We conducted a descriptive, cross-sectional study from December 2017 to March 2018 among secondary school students. We recruited 584 students, aged 10 to 18 years from 14 schools across the three Local Government Areas (LGAs) in Ilorin. We measured their blood pressure and anthropometrics following standard protocols and determined microalbuminuria in their early morning urine using Microalbumin 2-1 Combo strip and spot urinary albumin - creatinine ratio. Results: The prevalence of MA was 30.1%. MA was more common in obese and hypertensive adolescents (p &lt; 0.001 and p &lt; 0.01 respectively). Occurrence of MA correlated strongly with subject’s weight (r = 0.790, p = 0.004, p &lt; 0.01); systolic blood pressure (r = 0.884, p = 0.001, p &lt; 0.01) and body mass index (r = 0.710, p = 0.001, p &lt; 0.01). Independent predictors of MA were obesity, adjusted odds ratio (aOR) 4.9, (95% CI 1.124, 20.913), overweight (aOR 3.6, 95% CI 1.184, 10.174), older age (aOR 1.1, 95% CI 1.007, 1.219) and presence of systolic hypertension (aOR 3.1, 95% CI 1.903, 5.042). Conclusions: This study shows a high prevalence of MA among the adolescents. CVDs risk factors predictive of MA are overweight, obesity, systolic hypertension and older age.

Microalbuminuria and its associations with clinical profile and complications of type 2 Diabetes Mellitus

Background and Aims: Microalbuminuria is an early marker of diabetic nephropathy, which accounts for a significant reduction in life expectancy of diabetic patients. Timely detection of microalbuminuria facilitates appropriate preventive and therapeutic approaches to minimize risks. The aim of this study is to determine the prevalence and association of microalbuminuria with clinical profile and complications of type 2 diabetes mellitus.&#x0D; Methods: This study was a descriptive, cross sectional study involving 100 diabetic subjects between July 2018 to January 2019 at Bir Hospital. Microalbuminuria (mg/dl) was defined as spot urine albumin to creatinine ratio of 30-300 mg/g (Kidney Disease Improving Global Outcomes guidelines) in a single spot urine sample. Statistical analysis was done using Statistical package for the social sciences version 20.&#x0D; Results: Microalbuminuria was found in 35% of the sample and the rate was significantly higher among males (P =0.027). Microalbuminuria was significantly related to Body mass index (P = 0.018), duration of diabetes (P =0.000), retinopathy (P = 0.000) and stroke (P = 0.043). No statistically significant relation was found between microalbuminuria and age (P = 0.366), hypertension (P = 0.208), HbA1c (P = 0.098), dyslipidemia (P = 0.171) and ischemic heart disease (P = 0.651).&#x0D; Conclusions: This study shows high prevalence of microalbuminuria in Nepalese Type 2 diabetes mellitus. Screening for microalbuminuria should be done for all the type 2 diabetes mellitus patients for early detection and management of complications of diabetes mellitus.

Long-term impact of spironolactone compliance on microalbuminuria in patients with primary aldosteronism.

Patients with primary aldosteronism (PA) have a high prevalence of microalbuminuria (MAU), which leads to more severe systemic vascular damage. However, the primary recommended drug treatment for PA, spironolactone (SPL), has had poor patient compliance owing to its adverse effects, and the effect of SPL compliance on MAU has not been fully evaluated in patients with PA. We analyzed the effect of SPL compliance on endothelial dysfunction by assessing MAU in patients with PA. The study included 145 confirmed PA patients who received long-term medical treatment (mean, 5 years). As expected, compliance with SPL treatment improved patients' blood pressure and serum potassium levels. Patients with PA who complied fully with SPL treatment had a lower rate of MAU than noncompliant patients (13.73% versus 34.88%, respectively; P = 0.004). Multivariate logistic regression analyses adjusted for age and sex showed that continuous SPL treatment was associated with a lower presence of MAU (odds ratio, 0.319; 95% confidence interval, 0.135-0.750; P = 0.009). This association remained significant after further adjusting for other major risk factors. However, in the subgroup analysis, the protective effect against MAU was limited in compliant patients treated with ≥40 mg/day SPL compared with noncompliant patients (9.62% versus 34.88%, respectively; P < 0.05). Our findings demonstrated that in addition to improving high blood pressure and hypokalemia, full compliance with the appropriate dose of SPL may benefit endothelial function, as reflected by a lower prevalence of MAU in patients with PA.

Correlation between echocardiographic left ventricular hypertrophy and microalbuminuria among hypertensive subjects in Olabisi Onabanjo university teaching hospital, Sagamu, Nigeria

Background: Left ventricular hypertrophy is an adaptive response to volume and/or pressure overload, especially in hypertensive subjects. Microalbuminuria is a well-known predictor of poor cardiovascular outcomes in patients with hypertension. The purpose of this study was to determine the prevalence of microalbuminuria in hypertensive subjects and its relationship with LVH defined by echocardiogram in adult hypertensive subjects.Methods: The study was a cross-sectional comparative one involving 88 hypertensive volunteers with age and sex-matched normotensive controls. Detailed history, physical examination, urine assessment for microalbuminuria and echocardiogram were carried out on all participants.Results: The overall prevalence rate of microalbuminuria in the study was 29.5%. The prevalence of microalbuminuria in hypertensive subjects (43.2%) was significantly higher than in the normotensive counterparts (15.9%) (p=0.001). The prevalence of microalbuminuria in hypertensive subjects with echocardiographic LVH (81.0%) was significantly higher than in hypertensive participants without echocardiographic LVH (31.3%) (p=0.001). There was a positive correlation between left ventricular mass defined by echocardiogram and urinary albumin excretion in hypertensive subjects (r =0.422, p= 0.001).Conclusions: There is a high prevalence of microalbuminuria among hypertensive adults, especially those with left ventricular hypertrophy. There is also a positive correlation between echocardiographic left ventricular mass and urinary albumin excretion among adult hypertensive subjects.

Prevalence and Biomarkers of Diabetic Kidney Disease in Diabetic Patients on Treatment in Buea and Ngaoundere, Cameroon

Diabetic Kidney Disease (DKD) is a complication of diabetes that often leads to the End Stage Renal Disease. It is characterised by the presence of persistent albuminuria and a reduction of the Glomerular Filtration Rate (GFR) in diabetic condition. No study has revealed the prevalence of DKD in Cameroon. This cross-sectional study was conducted in Buea and Ngaoundere to determine the prevalence of DKD and characterize its biochemical profile in diabetic population under medical care. A total of 250 diabetics were enrolled with a mean age of 56.78±12.06 years, out of which 59.6% were diagnosed with Chronic Kidney Disease (CKD), 32.8% presented micro-albuminuria and 3.6% were diagnosed with macroalbuminuria. The prevalence of DKD was 15.2% out of which 78.9% were females (p=0.002). The prevalence of the co-morbidity hypertension and DKD was 8.8%. Significant association was found between DKD and two variables: female gender (OR: 2.28 (1.21-4.29); p=0.002) and hyper-creatinemia (OR: 3.47 (2.13-5.66); p < 0.001). The high prevalence of micro-albuminuria found in this study may reflect a high frequency of micro-albuminuria in diabetic population in Cameroon. This study is the first, to assess DKD in Cameroon according to the ADA consensus on CKD and diabetes. The findings showed that, diabetic complication is a serious problem in Cameroon and, more actions should be taken to improve its management.

Relationship between serum thyrotropin and urine albumin excretion in euthyroid subjects with diabetes.

Microalbuminuria represents vascular and endothelial dysfunction. Thyroid hormones can influence urine albumin excretion as it exerts crucial effects on the kidney and on the vascular system. This study explores the relationship between serum thyrotropin and urine albumin excretion in euthyroid patients with diabetes. A total of 433 patients with type 1 or 2 diabetes were included in this retrospective cross-sectional study. Data included anthropometric measurements and biochemical parameters from diabetes clinic. Males with urine albumin creatinine ratio >2.5 and female's >3.5 mg/mmoL were considered to have microalbuminuria. 34.9% of the patients had microalbuminuria. Prevalence of microalbuminuria increased according to TSH quartiles (26.9, 34.6, 38.5 and 44.9%, P for trend = 0.02). In a fully adjusted logistic regression model, higher TSH concentrations were associated with high prevalence of microalbuminuria (adjusted odds ratio 2.06 [95% CI: 1.14-3.72]; P = 0.02), while comparing the highest with the lowest quartile of TSH. Multiple linear regression analysis showed an independent association between serum TSH and urine albumin creatinine ratio (β = 0.007, t = 2.03 and P = 0.04). The risk of having microalbuminuria was higher with rise in TSH concentration in patients with younger age (<65 years), raised body mass index (≥25 kg/m2), hypertension, type 2 diabetes and hyperlipidaemia and age was the most important determinant ( P for interaction = 0.02). Serum TSH even in the euthyroid range was positively associated with microalbuminuria in euthyroid patients with diabetes independent of traditional risk factors. This relationship was strongest in patients with components of the metabolic syndrome.

Prevalence of Proteinuria and Albuminuria in an Obese Population and Associated Risk Factors.

Obesity has been increasingly recognized as a risk factor for kidney disease and both proteinuria and microalbuminuria have been associated with obesity. The actual prevalence of microalbuminuria and proteinuria in obese patients in the United States (US) has not been clearly described in the literature. Furthermore, obesity is associated with risk factors of kidney disease, such as diabetes and hypertension (HTN), and the prevalence of proteinuria and albuminuria excluding these risk factors is uncertain. In this study, we collected urine albumin/creatinine and urine protein/creatinine ratios on obese patients undergoing bariatric surgery to determine the prevalence of albuminuria and proteinuria in obese patients with and without associated diabetes and HTN. The study included 218 obese patients undergoing bariatric surgery at a New York City hospital. The mean age was 42.1 ± 11.3 years. The mean body mass index (BMI) was 43.9 ± 8.1. Diabetes (DM) was present in 25%. HTN was present in 47%. The prevalence of proteinuria and albuminuria was 21% (95% CI: 15.8–27.1%) and 19.7% (95% CI: 14.2–26.2%) respectively. Among those without DM but who had HTN, 22.6% (95% CI: 12.9–35) had proteinuria and 17% (95% CI 8.4–30.9) had albuminuria. Of patients with neither DM nor HTN, 13.3% (95% CI: 7.3–21.6) and 11% (95% CI: 5–17%) had proteinuria and albuminuria, respectively. Diabetics had a significantly higher prevalence of proteinuria and albuminuria than the non-diabetic groups. The non-diabetic groups did not differ significantly from each other in terms of prevalence of proteinuria and albuminuria. The BMI for diabetics did not differ from non-diabetics. On multivariate analysis, only the presence of diabetes was associated with proteinuria and albuminuria. BMI, age, and HTN were not predictive. In conclusion, we found a relatively high prevalence of microalbuminuria and proteinuria in an urban, US, obese population undergoing bariatric surgery. When diabetics were excluded, there was a lower prevalence. Even patients who had neither diabetes nor HTN, still, however, had much greater amounts than seen in the general US population, likely reflecting an adverse effect of obesity itself on renal physiology.

Prevalence of diabetic kidney disease before and after renal transplantation in Arab countries

Introduction The Arab world contains 22 countries with a total population of 362.5 million people. The prevalence of diabetes around the world has reached epidemic proportions. It already affects nearly more than 350 million people and is predictable to grow to more than 550 million people by 2035. The prevalence of diabetic kidney disease (DKD) in Arab countries is not well studied. The aim of the study was to review and present the prevalence of DKD among the Arabian population. Materials and methods We reviewed most of the published data − since the 1980s − in different Arabic countries regarding the prevalence of diabetes and DKD. Results The Arab countries with the highest prevalence of T2DM are: the Kingdom of Saudi Arabia (31.6%), Oman (29%), Kuwait (25.4%), Bahrain (25.0%), and the United Arab Emirates (25.0%). The lowest prevalence was found in Mauritania (4.7%) and Somalia (3.9%). Arab countries with high prevalence of micro-albuminuria included UAE, KSA, Bahrain, and Lebanon while KSA, Kuwait, Bahrain, and Egypt represented countries with the highest prevalence of macro-albuminuria. Low prevalence of DM and DKD was found in Iraq and Tunisia. These differences could be attributed to the genetic predisposition and the change in lifestyle. The cumulative incidence of PTDM at 12 months post-transplant was 17.6% in Sudan, 27% in KSA, 27% among the Egyptian liver transplants, 22.2% among the Egyptian kidney recipients, and 33% in Bahrain. There is no data available regarding diabetic kidney disease in renal transplant recipients in Arab countries. Conclusion Diabetic nephropathy is not an uncommon complication of diabetes (types 1 and 2) in Arab countries. Rapid economic growth in some Arabic speaking countries improved the infrastructure, but carries with it the burden of risk factors of DM. Large prospective collaborative studies are critically needed to explore this medical and socioeconomic problem among the Arab people before and after renal transplantation.

Predictive factors and prevalence of microalbuminuria in HIV-infected patients: a cross-sectional analysis

BackgroundRenal dysfunction is a common problem in the HIV+ population, due to the effect of both the HIV virus and the several classes of ARV drugs such as tenofovir (TDF). It is also known that the presence of renal damage correlates with cardiovascular risk and therefore with the risk of mortality of the patients accordingly. The detection of early renal damage is very important. Albuminuria and microalbuminuria are markers of early kidney disease and cardiovascular risk. The aim of the study is to evaluate the prevalence of microalbuminuria in a large polycentric sample, of unselected and consecutive HIV-patients followed as outpatients, and to assess its association with different therapeutic regimens.MethodsWe studied 326 patients with a mean age of 48.4 ± 1.6 years, treated at the Infectious Diseases Clinics of Chieti and Perugia for 48 weeks. The main metabolic parameters and the microalbuminuria levels in a single sample of urine were evaluated.ResultsMicroalbuminuria was detected in 61.0% of patients at T0 and in 49.7% after 48 weeks of observation with a median values of 1.1 mg/L (IQR: 0-2.7) vs. 0 mg/L (IQR: 0-2.0). 70% of the enrolled population did not show changes in microalbuminuria levels over time, 19% showed improvement, and 11% of the population had a worsening of microalbuminuria levels without any alteration of creatinine, uric acid and GFR-MDRD. We also found a statistically significant association between the development of microalbuminuria and gender (p < 0.035), Arterial Hypertension (AH) (p < 0.028) and therapy with TDF (p < 0.050).ConclusionWe showed a very high prevalence of microalbuminuria, much higher than the literature data; the use of TDF affects the renal function in a statistically significant way and should therefore be considered a risk factor for kidney damage, which can be early assessed with the measurement of microalbuminuria.

Microalbuminuria in Diabetic Patients in the Bamenda Health District

Diabetic nephropathy (DN) is the most common cause of end stage renal disease (ESRD) and it accounts for one third of all patients requiring renal replacement therapy in Africa. Diabetic patients with microalbuminuria (MA) have an increased risk of progression to macroalbuminuria and later to ESRD. So detecting MA which is a marker of DN helps to alert the clinician to intervene at a time when future renal damage is still preventable. The main goal of this study was to determine the prevalence of MA in diabetic patients at the Bamenda Regional Hospital. This study was a prospective cross sectional study involving diabetic patients at the Bamenda Regional Hospital. A random (spot) or first morning urine specimen was collected and MA was measured by a semi quantitative dipstick method using the URS-14H urine test strips. The prevalence of MA in the present study was 34.6%, which is high but similar to the results of other studies done in sub-Saharan Africa. Although MA was more common (50%) in individuals with diabetes more than 16 years, a high proportion (42.85%) of patients with MA had a duration of diabetes of ≤ 5years. There was no significant difference in the occurrence of MA with respect to age, gender and duration of diabetes. This study showed a high prevalence of MA in the diabetic population presenting at the Bamenda Regional Hospital. Consequently, measures of glycemic control should be enhanced in this population to prevent the progression to macroalbuminuria and ESRD.

Prevalence and risk factors of microalbuminuria in type 2 diabetes mellitus

Background: Microalbuminuria, which arises very early in the disease and is one of the first markers for diabetic nephropathy, is an independent risk factor for cardiovascular disease. This study was conducted to estimate the prevalence and the risk factors of microalbuminuria in type 2 diabetes mellitus. Methods: 246 patients having type 2 diabetes mellitus were included in the study wherein age, sex, duration of the diabetes and body mass index were noted. Blood pressure was taken for all the patients for detection of hypertension and blood was collected after fasting for a minimum of 12 hour for fasting blood sugar, glycosylated hemoglobin (HbA1C), serum cholesterol, and serum triglyceride levels. Results: Out of the 246 patients, 185 (75.2 %) of the patients had normal levels of albumin while 61(24.8%) of them had microalbuminuria. Incidence of males was more common and the mean age in which diabetes was detected among the patients enrolled was in the early 40s. High systolic blood pressure with mean value 135, fasting blood sugar 172, cholesterol 181, HbA1C 8.7 was observed among the patients. The average duration of diabetes was found to be 9 years among the patients with microalbuminuria. Conclusions: There is a high prevalence of microalbuminuria among the patients with diabetes type 2 in our geographical area. Hypertension, duration of diabetes, fasting blood sugar, HbA1c were found to be the risk factors. Therefore, the early identification of patients at greatest risk, and the subsequent initiation of renal and cardiovascular protective treatments, are of the utmost importance.

Relationship of arterial compliance and blood pressure with microalbuminuria and mildly decreased glomerular filtration rate: a Chinese community-based analysis.

ObjectiveThis analysis is designed to determine the prevalence of microalbuminuria (MAU) and mildly decreased glomerular filtration rate (GFR); to investigate the association of augmentation index (AIx), central blood pressure (cBP) and peripheral blood pressure (pBP) with MAU and mildly decreased GFR; and to compare the association strength of cBP and pBP with MAU and mildly decreased GFR.MethodsThis community-based analysis included 2071 Chinese residents. Urine albumin-to-creatinine ratio (UACR), GFR, and pulse wave measurements were performed. UACR of 30–299 mg/g and GFR of 60–89 ml/min/1.73 m2 were identified as MAU and mildly decreased GFR.ResultsThe prevalence of MAU and mildly decreased GFR was 21.3% and 33.2%. The AIx, cBP and pBP were significantly higher in participants with MAU compared with those without MAU, and in participants with mildly decreased GFR compared with those without mildly decreased GFR (all P<0.001). After participants were categorized into four subgroups based on the presence or absence of MAU and mildly decreased GFR, Aix, cBP and pBP progressively increased from the subgroup without both of MAU and mildly decreased GFR to the subgroups with either one of them, and arrived at top in the subgroup with both of them (all P<0.001). Compared with the reference category without MAU and mildly decreased GFR, the odd ratio values significantly increased from the category with either one of MAU and mildly decreased GFR to the category with both of them (all P<0.001). The AIx, cBP and pBP were all independently associated with MAU and mildly decreased GFR after full adjustment (all P<0.05), and the association strength of MAU and mildly decreased GFR with cBP was similar to those with pBP.ConclusionsIn Chinese community-dwelling population, there was a high prevalence of MAU and mildly decreased GFR. The AIx, cBP and pBP were all independently associated with MAU and mildly decreased GFR; meanwhile, cBP did not exhibit stronger association with MAU and mildly decreased GFR compared with pBP.

Evaluation of microalbuminuria in obese adolescents

Background: Obesity is a risk factor for metabolic syndrome with insulin resistance. Its effect on renal and cardiovascular diseases is reported in developed countries, but rarely established among adolescents in developing countries.Subjects and methods: A crosssectional study of 846 adolescents selected from 12 secondary schools in Port Harcourt, Nigeria. Obese subjects with Body Mass Index (BMI) equal to or greater than the 95th percentile for age and sex on the United States CDC growth chart were selected and studied. Urine samples of subjects without overt proteinuria were tested for microalbuminuria using the micral test strips.Results: Seventy-three of the subjects were obese giving the prevalence of obesity to be 8.6%. Microalbuminuria was present in 23 (35.4%) of the 65 obese subjects without overt proteinuria. The proportional prevalence was higher in females (42.9%), in age group 10-14years (42.2%), in subjects with hypertension (57.1%), and family history of hypertension (50.0%) and diabetes mellitus (37.5%) [p &gt; 0.05].Conclusion: There is high prevalence of adolescent obesity, and a high prevalence of microalbuminuria among obese adolescents in Port Harcourt. We recommend efforts at reducing obesity as a means of preventing renal disease in adolescents.

Smoking is associated with a high prevalence of microalbuminuria in hypertensive high-risk patients: data from I-SEARCH

Microalbuminuria (MAU) is a marker of endothelial dysfunction and a predictor of cardiovascular events. The effects of cigarette smoking on the prevalence of MAU in a high-risk population with arterial hypertension are unclear. The International Survey Evaluating Microalbuminuria Routinely by Cardiologists in patients with Hypertension (I-SEARCH) documented the clinical profile of 20,364 patients with arterial hypertension and cardiovascular risk factors. In this population, 13,690 patients had no history of smoking, 4,057 patients were former smokers and 2,617 patients were current smokers. The prevalence of MAU was associated with the smoking status. Consumption of 1-20 cigarettes per day leads to an increase of 6.8% in the prevalence of MAU compared to non-smokers (P < 0.001). Smoking of >20 cigarettes per day was associated with a 12.5% higher prevalence of MAU compared to non-smokers, while former smokers had a 4.7% higher prevalence of MAU. Multivariable analysis revealed that smoking was independently associated with MAU [odds ratio (OR) smoking vs. non-smoking 1.16; 95% confidence interval (CI) 1.01-1.33; P < 0.05]. Particularly, a consumption of >20 cigarettes per day was associated with high odds for MAU (OR 1.33; CI 1.01-1.75; P < 0.05). Interestingly, independently of blood pressure, the use of an angiotensin receptor blocker and an ACE was associated with significantly reduced odds ratio for MAU in the smoking group, while there was no significant association in the non-smoking group. The prevalence of MAU in hypertensive patients is higher in smokers than in non-smokers with a strong dose dependency.