Micral Test Strips Research Articles

Association of Microalbuminuria with Abnormal Left Ventricular Geometry Patterns in Nigerian Normotensive Type 2 Diabetic Patients

To compare left ventricular (LV) geometry patterns among normotensive type 2 diabetics (NT2DM) with normoalbuminuria, NT2DM with microalbuminuria and healthy controls. A cross-sectional study conducted at the medical outpatient department of a Teaching Hospital from January 2013 to March 2014. Sixty-three normoalbuminuric NT2DM, 71 microalbuminuric NT2DM and fifty-nine healthy controls were recruited. Microalbuminuria was tested for using Micral test strips (Roche, Germany). Trans-thoracic echocardiography was carried out on all subjects. Relative wall thickness (RWT), left ventricular mass index (LVMI) and LV geometry patterns were compared among the three groups. The three groups were age and sex-matched and appropriate statistical tests were used for comparisons with p<0.05. The proportions of abnormal LV geometry (33.3% vs 71.4% vs 84.5%), LVMI and RWT showed a significant stepwise increase from healthy controls through normoalbuminuric NT2DM and to microalbuminuric NT2DM (all p<0.01). Concentric remodeling (CR) was the commonest pattern among the three groups. Left ventricular mass index and RWT correlated significantly with duration of DM and body mass index (all p< 0.01). Microalbuminuria showed a strong direct association with abnormal LV geometry (OR 3.27, 95% CI 1.63-6.57, p<0.01) while duration of DM was found to be an independent predictor of LV geometry remodeling (OR 1.23, 95% CI 1.02-1.49, p = 0.03) among normotensive diabetics. Although CR was the commonest pattern across the three patient groups, those with microalbuminuria had the highest proportion and risk of LV remodeling. Early screening and prompt treatment of microalbuminuria in NT2DM is hereby recommended.

Prevalence and correlates of microalbuminuria in Yemeni children with sickle cell disease.

Microalbuminuria (MA) has been recognized as a sensitive marker of early glomerular injury and a predictor of kidney dysfunction in patients with sickle cell disease (SCD). Limited data are available about MA in SCD children in the Arab countries and none from Yemen. The aim of this study is to determine the prevalence and correlates of MA among 101 children aged 1-16 years, with SCD at their steady state. Children were recruited during their routine health-care visits to the pediatric outpatient clinic in Al-Sadaqa general teaching hospital, Aden, Yemen, between September 2014 and February 2015. A random spot urine sample for each child was screened for MA using Micral-Test strips method. Data on clinical history, anthropometry, blood pressure (BP), and laboratory investigations were obtained. The overall prevalence of MA in this sample was 30.7%, with male predominance (80.6%) (P <0.05). The mean age of children with MA was 7.5 ± 3.2 years, and 10% of them were under five years of age. MA was correlated to both hemoglobin and hematocrit levels, which found to have protective effect against MA (Odds ratio = 0.17 and 0.59, respectively, P <0.05). No correlations were found between MA with age, height, weight, body mass index, recurrent clinical events (painful crises, blood transfusions, and hospitalizations), or fetal hemoglobin levels. BP measurements for all individuals were within the normal ranges, but systolic and diastolic BP were significantly higher in those with MA than without. This study demonstrated a high prevalence of MA in Yemeni children with SCD, and affecting young children as early as 2.5 years of age. Screening for MA as one of the early renal injury markers in children with SCD may help in the prevention of permanent loss of renal function and subsequent renal insufficiency in adulthood.

Microalbuminuria among participants with high-normal blood pressure attending a tertiary health institution in Nigeria

Background: Participants with high-normal blood pressure (BP) (systolic BP [SBP] 130–139 mmHg and/or diastolic BP [DBP] 85–89 mmHg) have higher cardiovascular disease (CVD) risk factors compared with optimal BP (SBP In the present study, the prevalence of microalbuminuria, factors associated with it, and other CVD risk factors were assessed among participants with high-normal BP in comparison to controls. Methods and Results: Out of 200 participants screened, 92 with high-normal BP (Group 1) and 97 with optimal BP (Group 2) who had no history of hypertension or diabetes mellitus were consecutively recruited after satisfying the inclusion criteria. Microalbuminuria was determined using Micral test strips using first-morning urine sample. The mean age of participants in Group 1 was 33.39 ± 5.17 years, while that for Group 2 was 27.01 ± 7.4 years (P ≤ 0.001). The prevalence of microalbuminuria was higher among participants in Group 1 than in participants in Group 2 (12.9% vs. 4.1%, P = 0.037). Participants in Group 1 were older, had higher mean SBP, DBP, body mass index (BMI), fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol, and triglycerides than those in Group 2. Pearson's correlation coefficient showed a significant association between BMI and microalbuminuria among all the study participants (r = 0.625, P ≤ 0.007), and the BMI explains 37.7% of the variability of urinary albumin excretion among participants (R2 = 0.377, P = 0.007). Conclusion: Participants with high-normal BP had a higher prevalence of microalbuminuria and risk factors for CVD than those with optimal BP. The results suggest that participants' BMI is linked to urinary albumin excretion, and if proven in larger studies, the findings might be useful in the early prevention of CVD among individuals with high-normal BP.

Comparison of the Efficacy of Serum Creatinine and Microalbuminuria in Early Diagnosis of Renal Injury in Asphyxiated Infants in Calabar, Southern Nigeria

Background: Microalbuminuria and serum creatinine are the specific markers of acute renal injury. Perinatal asphyxia is responsible for 50% of all neonatal deaths and nonoliguric acute renal injuryis one of its complications. This study was undertaken to determine the efficacy of serum creatinine and microalbuminuria for early diagnosis of renal injury in severely asphyxiated neonates in Calabar, Nigeria.Methods: This prospective cross-sectional study was performed among severely asphyxiated newborns admitted into the neonatal wards of the University of Calabar Teaching Hospital (UCTH). Standard methods for the determination of blood urea and electrolyte were executed. Micral-test strips have been applied using urine dipstick and the result of the test was negative only for albumin. The developed colors have been compared five minutes after the first test.Results: Fifty full-term newborns were enrolled and their serum electrolytes, creatinine and the creatinine clearance were essentially normal. Six neonates demonstrated positive results in the microalbominuria assessment, while the rest were negative in this regard. The test has 0% sensitivity and 100% specificity, while the positive and negative predictive values were 0% and 88%, respectively.Conclusion: Microalbuminuria is not a useful marker for early diagnosis of acute renal failure in the newborns with severe prenatal asphyxia, but further studies are recommended.

Comparative Efficacy of Serum Creatinine and Microalbuminuria in Detecting Early Renal Injury in Asphyxiated Babies in Calabar, Nigeria

Background: Microalbuminuria and serum creatinine are markers of acute kidney injury. Birth asphyxia is responsible for 50% of all newborn deaths and acute non-oliguric kidney injury is one of such complications. This study was undertaken to determine the efficacy of serum creatinine and microalbuminuria for the detection of early renal lesion in severely asphyxiated babies in Calabar, Nigeria. Materials and Method: This prospective cross-sectional investigational study was undertaken among severely asphyxiated babies admitted into the newborn units of the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. Standard method for blood collection and determination of urea, electrolytes were used. Micral-test strips were used on samples negative only for albumin after using urine dipstick. Color comparison was done with the standardized color scale on test strip container after 5 minutes. Results: Fifty term newborn babies were enrolled, their serum electrolytes, creatinine and creatinine clearance were essentially normal. Six (12%) babies had positive microalbuminuria, while 44(88%) had negative microalbuminuria with specificity and negative predictive values of 100% and 88% respectively. Conclusion: Microalbuminuria was not useful for early detection of acute renal failure in babies with severe birth asphyxia, but further studies are recommended.

Prevalence of Microalbuminuria among secondary school children

Microalbuminuria is an early sign of kidney and cardiovascular damage. Therefore, early detection in asymptomatic individuals may be helpful in preventing deterioration in renal function. We carried out a cross-sectional study of 820 secondary school students aged 10 - 19 years from September to November 2008. The urine samples of 615 (75.0%) without overt proteinuria and haematuria were tested for microalbuminuria using the micral test strips. Values of greater than 20mg/L were considered positive. There were 299 (48.6%) males and 316 (51.4%) females, with a M:F ratio of 1:1.1. The prevalence of microalbuminuria as seen in 214 of the students was 33.2%. It was significantly higher in females (45.3%), obese subjects (35.4%), those with hypertension (70.6%), those with positive family history of hypertension (59.5%), and diabetes mellitus (46.4%). Microalbuminuria was found in 1 of the 2 subjects who had features of DM and in one subject with sickle cell anemia. The prevalence of microalbuminuria in Nigerian adolescents is high. We recommend routine screening for microalbuminuria in adolescents for early detection and prevention of renal damage.

Screening for microalbuminuria in newly diagnosed type 2 diabetics at a staff clinic in Port Harcourt

Background: Most individuals working in the Nigerian National Petroleum Company (NNPC) Port Harcourt are obese (with BMI> 29 kg/m2). This has been attributed to change in diet and life style. Most of these individuals present with type 2 diabetes. Individuals with diabetes are at higher risk of suffering renal damage. It is observed that in spite of the medical facilities made available to these company workers, they do not present early for management but rather present when diabetic complications have set in to worsen outcome of management. Aim: To study the prevalence of microalbuminuria (as an evidence of onset of renal complication of diabetes) in newly diagnosed type 2 diabetics and its possible relationship with other diabetic complications in this group of patients. Methods: In this prospective study, 60 newly diagnosed type 2 diabetics were tested for microalbuminuria using micral test strips. Subjects and controls were also assessed for retinopathy, hypertension and glycated haemoglobin levels. Results: Microalbuminuria was present in 38 (63.3%) patients and was found to be significantly associated with mean arterial pressure, systemic hypertension, glycated haemoglobin levels and diabetic retinopathy (p

Screening for microalbuminuria amongst medical students in University of Benin, Nigeria: a pilot study

Microalbuminuria, a predictive tool in both diabetics and hypertensive, is associated with an increase in vascular mortality and morbidity in the healthy population. A cohort of apparently healthy medical students was screened for microalbuminuria using micral test strips. Data on history of hypertension, diabetes mellitus, renal disease and smoking were collected using a self-administered structured questionnaire. Blood pressure and body mass index (BMI) were recorded in all subjects. Microalbuminuria was present in 61% of the students. It was commonly encountered in students who are smokers, have a family history of diabetes mellitus and hypertension. BMI of students with normoalbuminuria was significantly lower than in students with MA (p = 0.012). MA positively correlated with BMI (r = 0.13, p = 0.40). Microalbuminuria is alarmingly prevalent in the group of students studied and may probably predate clinical diagnosis of diabetes mellitus and hypertension. There is need for follow-up and close monitoring of students who have been identified to have MA, as early preventive strategies may be useful. Key Words: Screening, microalbuminuria, healthy students (Jnl Med. & Biomed Res.: 1(2) 2002: 29-33)