Prevalence Of Microalbuminuria Research Articles

Biochemical markers of renal functions in hypothyroidism – A study in Indian population

The global burden of hypothyroidism is significant among the disorders of thyroid gland. In the developed world, hypothyroidism prevalence is approximately 4-5% and that of subclinical hypothyroidism is approximately 4-15%.The present study was done to evaluate the association between thyroid function and renal parameters among euthyroid, subclinical and overt hypothyroid individuals. To evaluate the renal functions in hypothyroid patients. To estimate & compare, freeT3, freeT4, TSH, serum creatinine, urea and uric acid, eGFR, urinary microalbumin, urinary creatinine levels in euthyroid (control group) & hypothyroid patients (study group).To calculate & compare urinary albumin to creatinine ratio (UACR) in both groups (control group and study group). This is a Cross sectional analytical study carried out at Clinical Chemistry Laboratory, at Sir Sayajirao General Hospital (S.S.G.H) and Medical College Baroda, Vadodara. Study subjects were divided into three groups depending upon the levels of the TSH and free T4.The Chemiluminescent Immunoassay (CLIA) was used to measure: S.TSH, fT4 and fT3 levels by micro particle enzyme immunoassays.The Fully automatic Erba XL 640 was used to measure-Serum Creatinine, Serum Urea, Serum Uric acid were measured on Erba XL 640. The semiautomatic Microlab RX-50V was used to measure-Urinary Microalbumin.All statistical analysis was done by using MedCalc statistical software. ANOVA comparison analysis, we found significant differences in mean results of several parameters in three thyroid groups. In overt hypothyroid subjects, free T4 levels showed significantly moderate strong negative correlations (p=0.002, r= -0.412 & p<0.001, -0.539) with UACR & urinary microalbumin. In overt hypothyroid group, Serum TSH: levels showed weak positive correlations (p=0.04, r=0.28) with urinary creatinine, moderately strong positive correlations with UACR and urinary microalbumin (p=<0.001, r=0.57 & p=<0.001, r=0.72). Serum TSH: In subclinical hypothyroid groups, TSH levels showed positive correlations with serum uric acid urinary creatinine, UACR, and urinary microalbumin (p=0.01, r= 0.32, p=0.00, r= 0.46, & p=<0.001, 0.43). Present study were found increased levels of serum creatinine, uric acid, urine albumin creatinine ratio, urinary microalbumin and decreased eGFR levels in hypothyroid group as compared to euthyroid group. The prevalence of microalbuminuria and urine albumin creatinine ratio is high in overt hypothyroidism.

Association between triglyceride to high-density lipoprotein cholesterol ratio and microalbuminuria in the Chinese population

The evidence for the association between the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-c) ratio and the risk of developing microalbuminuria is still limited in the Chinese population. Therefore, our research will endeavor to explore the relationship between the two. The cross-sectional survey enrolled 32,877 general population from eight regional centers in China. If the urinary albumin-creatinine ratio (UACR) ≥ 30 mg/g, it was considered microalbuminuria. The dependent variable in the study was microalbuminuria, while the independent variable was the TG/HDL-c ratio. A binary logistic regression model was utilized to examine the independent association between the likelihood of microalbuminuria and the TG/HDL-c ratio. A generalized additive model (GAM) and spline smoothing were employed to investigate non-linear relationships between these two variables. To confirm the findings and pinpoint important turning points, subgroup and threshold effect tests were performed. The average age of the study participants was 57.67 ± 9.29 years, with 22,052 (67%) females and 10,825 (33%) males. The ratio of TG/HDL-c had a median value of 1.06, while the UACR had a median value of 9.92 mg/g. The prevalence of microalbuminuria was 14.4%. Following covariate adjustment, the prevalence of microalbuminuria and the TG/HDL-c ratio showed a significant positive connection (OR = 1.17,95% CI 1.13–1.21). Interestingly, we discovered a non-linear relationship between the occurrence of microalbuminuria and the TG/HDL-c ratio. At a TG/HDL-c ratio of 0.911, we detected an inflection point, with ORs of 1.12 (95% CI: 1.08, 1.17) on the right side of the point and 1.89 (95% CI: 1.51, 2.36) on the left. Subgroup analyses further validated the results. Our research revealed a positive and non-linear connection between the TG/HDL-c ratio and the prevalence of microalbumin in Chinese individuals. The connection was especially robust when the TG/HDL-c ratio was below 0.911. Reducing TG or raising HDL-c levels in order to lower the TG/HDL-c ratio may significantly mitigate the risk of microalbuminuria.

PREVALENCE OF ALBUMINURIA IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Albuminuria, the presence of albumin in the urine, is a critical biomarker of renal damage, particularly in patients with type 2 diabetes mellitus (T2DM). Objective: The basic aim of the study is to find the prevalence of albuminuria in patients with type 2 diabetes mellitus. Methods: This Cross-sectional study was conducted at the Department of Medicine, PAF Hospital Mushaf, Sargodha from June to November 2024. Data were collected through a non-probability/consecutive sampling technique. A sample of 176 patients, based on a 34% prevalence of microalbuminuria in type 2 diabetes patients from a previous study. Results: Data were collected from 176 patients with a mean age of 48.5 years (SD = 8.2). The sample comprised 51% males and 49% females. The average Body Mass Index (BMI) was 29.2 ± 4.5, with 45% classified as obese (BMI ≥ 30). The mean duration of diabetes was 9.3 years (SD = 4.5), with 38% of patients having had diabetes for over 10 years. A significant proportion (68%) were hypertensive, and smoking status was distributed as 23% current smokers, 28% former smokers, and 49% non-smokers. Regarding physical activity, 40% were sedentary, while 17% managed their diabetes through diet, 51% used oral medications, and 32% relied on insulin. Out of 176 patients, 47% (83 patients) had no albuminuria, while 53% (93 patients) exhibited some degree of albuminuria. Specifically, 37% (65 patients) had microalbuminuria with albumin-to-creatinine ratios between 30-300 mg/g, and 16% (28 patients) had macroalbuminuria with ratios above 300 mg/g. Conclusion: It is concluded that albuminuria is highly prevalent among patients with type 2 diabetes mellitus, with significant associations observed with age, duration of diabetes, hypertension, obesity, and lifestyle factors such as physical inactivity and smoking.

Microalbuminuria as an Integrated Biomarker for Cardiovascular Risk Stratification and Early Renal Dysfunction in Patients with Essential Hypertension

Background: Microalbuminuria, defined as the excretion of 30–300 mg of albumin in the urine per day, is an early marker of renal impairment and cardiovascular complications. In essential hypertension, it may signify heightened end-organ damage. Objectives: To determine the prevalence of microalbuminuria in hypertensive patients and evaluate its utility as a biomarker for early renal impairment and cardiovascular risk stratification. Methods: This study, conducted at Nishtar-II Tertiary Care Hospital, Multan, from February to September 2024, included 200 hypertensive patients aged 20–60 years. Spot urine samples assessed microalbuminuria, while cardiovascular risk was evaluated using the Framingham Risk Score. Renal function was assessed via blood creatinine, estimated glomerular filtration rate (eGFR), and albumin-to-creatinine ratio (ACR). Statistical analysis, including multivariate regression, identified predictors and correlations. Results: Microalbuminuria prevalence was 38%. Patients with microalbuminuria had significantly higher BMI, systolic/diastolic blood pressure, and ACR (p < 0.05). Independent predictors included BMI (OR = 1.25), systolic BP (OR = 1.15), blood creatinine (OR = 1.52), and ACR (OR = 1.02). A strong inverse correlation between eGFR and microalbuminuria (r = -0.45, p < 0.001) highlighted early renal impairment. Conclusion: Microalbuminuria serves as a significant biomarker for cardiovascular and renal risk in hypertension. Routine screening can identify high-risk individuals early, enabling timely interventions to prevent disease progression.

Performances of Proteinuria as Compared with Albuminuria in Screening for Microalbuminuria During Sickle Cell Anaemia

Albuminuria is the gold standard for the screening of microalbuminuria, a biomarker of early onset of nephropathy during sickle cell anemia (SCA). Nephropathy increase morbidity and mortality of SCA in the absence of appropriate treatment. However, albuminuria is not readily available or affordable in resource-limited countries, so in 2012 Kidney Diseases Improving Global Outcomes (KDIGO) proposed using proteinuria at a threshold of 150 mg/g urine creatinine to screen for microalbuminuria in these settings. The aim of this study was therefore to assess the performance of proteinuria in screening microalbuminuria in sub-Saharan Senegalese sickle cell patients. Albuminuria in recruited SS sickle cell patients was expressed as a urine albumin-to-creatinine ratio (UACR) and proteinuria as a urine proteins-to-creatinine ratio (UPCR). The prevalence of microalbuminuria, Cohen's kappa coefficient and areas under the curve (AUC) were then determined to assess the performance of proteinuria in detecting microalbuminuria. A total of 150 patients with a median age of 20 years [minimum-maximum: 4-57] and a female proportion of 51.33% were included in the study. Microalbuminuria was present in 42.38% (n=64) of subjects according to the UPCR. The Cohen's kappa coefficient was 0.41 [IC95%: 0.27-0.56] and the AUC 0.71 [IC95%: 0.64 - 0.81] with UPCR 150mg/g. The best Cohen's kappa coefficient and AUC were observed with an UPCR threshold of 135 mg/g. Our results confirm that proteinuria is useful in screening for microalbuminuria and show that RPCU 135 mg/g would be the optimal cut-off for detecting microalbuminuria in Senegalese sickle cell anemia patients.

#1620 Association of dietary live microbe intake with chronic kidney disease based on baseline characteristics of national population: NHANES 2011-2018

Abstract Background and Aims The gut microbiota plays a crucial role in a variety of diseases, including chronic kidney disease (CKD). The gut-kidney axis is mediated through metabolism dependent pathways. The relationship between CKD and the dietary consumption of live microbes has not been explicitly studied. Probiotic food intake may play a beneficial role in human health including the gut microbiota. However, in addition to probiotic foods, live micro-organisms are also found in other food products, such as raw vegetables and fruits. In this study, we adjusted for the potential association between dietary live microbiome intake and chronic kidney disease (CKD) in different baseline characteristics, including kidney function status. Method A total of 22,039 subjects were included in the study. We used data from the US National Health and Nutrition Examination Survey 2011-2018. Based on a 2-day 24-hour dietary recall, the dietary intake of the live microbiome was adjusted and the participants were categorized into three groups: low (<104 CFU/g), medium (104–107 CFU/g), or high (>107 CFU/g) dietary intake of live microbes, according to the classification system for the dietary intake of live microbes and participants’ 24-hour dietary recall data. Low intake was used as a reference. Stage 3 CKD with high risk of progression was defined by a combination of estimated glomerular filtration rate (GFR-EPI <60 mL/min/1.73 m2) and urinary albumin-to-creatinine ratio (uACR >30 mg/g was defined as microalbuminuria). CKD was defined by a combination of GFR-EPI <60 mL/min/1.73 m2 or uACR, >30 mg/g. Albuminuria was defined as uACR >300 mg/g. The analyses used weighted logistic regression models (crude model and first, adjusted for age, gender, race, education and second, adjusted for hypertension, diabetes, total cholesterol level, BMI, hemoglobin level, total calorie intake, GFR and serum creatinine level). Results After model adjustment (Model 2, p< 0.0001), women in the medium dietary live microbe intake group had a low prevalence of stage 3 CKD with high risk of progression in contrast to those in the low dietary live microbiome intake group (OR: 0.913, 95% Cl: 0.63-1.32, p< 0.01), between high and low group (OR: 0.333, 95% Cl: 0.13-0.86, p< 0.01). However there was no significant association in men. In model 2, patients in the medium dietary live microbiome intake group had a low prevalence of microalbuminuria in contrast to those in the low dietary live microbiome intake group (OR: 0.789, 95% Cl: 0.63-0.98, p< 0.05). In model 2, we also found the significant association with albuminuria between high and low (OR 0.784, 95% Cl: 0.63-0.98, p< 0.05), medium and low (OR: 0.572, 95% Cl: 0.33-0.98, p< 0.05) dietary live microbiome intake patient groups. In model 2, those in the medium dietary live microbe intake group had a low prevalence of CKD in contrast to those in the low dietary live microbiome intake group (OR: 0.896, 95% Cl: 0.82-0.98) p< 0.01), but there was no significant association between the high and low dietary live microbiome intake groups. Conclusion In this study, a medium or high dietary live microbiome intake was associated with a low prevalence of stage 3 CKD with ahigh risk of progression in women. A medium dietary live microbiome intake was associated with a low prevalence of chronic kidney disease or microalbuminuria in the population. A medium or high dietary live microbiome intake was associated with a low prevalence of albuminuria. A medium dietary live microbiome intake was associated with a low prevalence of microalbuminuria.

Target organ damage in untreated hypertensive patients with primary aldosteronism.

An increased risk of target organ damage (TOD) has been reported in patients with primary aldosteronism (PA). However, there is relatively little related research on the correlation between the degree of TOD and those with and without PA in newly diagnosed hypertensive patients. The aim of this study was to assess the association between PA and TOD among patients with newly diagnosed hypertension. Newly diagnosed hypertensive patients were consecutively recruited from January 2015 to June 2020 at the University of Hong Kong-Shenzhen Hospital. Patients were stratified into those with and without PA. Data for left ventricular mass index (LVMI), carotid intima-media thickness (CIMT) and plaque, and microalbuminuria were systematically collected. A total of 1044 patients with newly diagnosed hypertension were recruited, 57 (5.5%) of whom were diagnosed with PA. Patients with PA had lower blood pressure, serum lipids, body mass index, and plasma renin activity and a higher incidence of hypokalemia than those without PA. In contrast, the prevalence of left ventricular hypertrophy, increased CIMT, and microalbuminuria was higher in patients with PA than in those without PA. Multivariable regression analysis demonstrated that PA was independently associated with increased LVMI, CIMT and microalbuminuria. Among patients with newly diagnosed hypertension, those with PA had more severe TOD, including a higher LVMI, CIMT and microalbuminuria, than those without PA. These findings emphasize the need for screening TOD in newly diagnosed hypertension due to underlying PA.

INTERMEDIATE AND LONG-TERM BLOOD PRESSURE OUTCOMES IN POSTPARTUM HYPERTENSION – AN INTERIM ANALYSIS OF THE BASEL POSTPARTUM HYPERTENSION REGISTRY

Objective: Postpartum hypertension (PPHT) affects 10% of all pregnancies and has various aetiologies including chronic hypertension (CH), hypertensive disorders of pregnancy (HDP) including preeclampsia (PE), and de novo PPHT. Women with PPHT are at an elevated risk for persistent hypertension and for developing cardiovascular and renal disease, but most outcome data is based on PE. Here, we investigated mean 24-hour blood pressure (24hBP) and renal target organ damage using microalbuminuria as a surrogate marker in the intermediate and long-term postpartum period. Design and method: In total 370 participants were prospectively enrolled in the PPHT registry including women with HDP and/or PPHT. 24hBP measurement and urinary analysis were conducted 3 (V3) and 12 (V12) months after delivery. Normotensive 24hBP was defined as mean systolic/diastolic 24hBP <130/<80 mmHg and microalbuminuria was defined as albumin/creatinine ratio >= 3 mg/mmol. Results: The mean age was 34.0 (±5.4) years. The proportion of CH was 44/370 (11.9%), gestational hypertension 118/370 (31.9%), preeclampsia, eclampsia or HELLP 205/370 (55.4%) and de novo PPHT 68/370 (18.4%). Data regarding V3 and V12 was available in 246 and 114 participants. Antihypertensive treatment was prescribed at baseline, V3, and V12 in 85.4%, 18.7% and 18.4% of participants. Prevalence of microalbuminuria at baseline, V3, and V12 was 84.9% 29.9%, and 16.9% respectively. The mean (±standard deviation) systolic 24hBP at V3 was 121.7(11) mmHg and mean diastolic 77.3(8.6) mmHg respectively. At V12, mean systolic 24hBP was 119.5(8.5) mmHg and diastolic 24hBP 75.6 (6.9) mmHg. Detailed 24hBP values and proportions of systolic and diastolic blood pressure control in participants with and without antihypertensive treatment are presented in Table 1. Conclusions: One year after giving birth, elevated albumin/creatinine ratio as a surrogate for renal target organ damage persisted in approximately 1 out of 6 participants. Blood pressure control was documented in approximately 3/4 of the participants at the one-year postpartum follow-up. Nevertheless, a relevant number of participants were hypertensive or still under treatment one year after birth. Therefore, continued follow-up and cardiovascular risk assessment in this population should be warranted.

Microalbuminuria as a Predictor of Early Neurological Deterioration and Poor Functional Outcomes in Acute Ischemic Stroke.

Background Ischemic stroke is a major health crisis with significant consequences. Microalbuminuria, a sign of endothelial dysfunction, has been linked to adverse outcomes in ischemic stroke. Early neurological deterioration (END) is a critical factor influencing the patient's prognosis. This study aimed to determine the prevalence of microalbuminuria, its predictive value in assessing END, and its prognostic implications in acute ischemic stroke (AIS). Methodology This study conducted at Pradyumna Bal Memorial Hospital, Kalinga Institute of Medical Sciences Bhubaneswar (November 2020-April 2022) included 114 AIS patients over 18 years who presented within 24 hours of stroke onset. Demographics, vascular risk factors, National Institutes of Health Stroke Scale (NIHSS) scores (admission and day three), modified Rankin scores (day 10), urinary albumin-to-creatinine ratios, and carotid artery Doppler studies were collected. Results The mean age of the patients was 61.87 years, with males constituting 72.8% of the population. Hypertension (50.9%) and diabetes mellitus (28.9%) were the most common comorbid conditions. The mean NIHSS stroke severity at presentation was 11.30. END occurred in 38.6% of patients. Overall, 43.9% of cases showed carotid stenosis, and the mean carotid intimal media thickness was 1.08 mm. Notably, the presence of microalbuminuria significantly increased the chances of both END (39.45 times higher risk) and worse functional outcomes (odds ratio = 19.147, p = 0.001). Conclusions Microalbuminuria emerges as a robust independent predictor of END and a poor prognosis in AIS. These findings highlight the importance of early microalbuminuria identification and intervention to reduce END risk and potentially improve outcomes in AIS patients.

Prevalence and the factors associated with microalbuminuria among patients with type 2 diabetes mellitus and/or hypertension in the urban areas of Puducherry district: a cross-sectional study.

Microalbuminuria is an early indicator for renal and cardiovascular diseases, especially among patients with diabetes mellitus (DM) and hypertension (HTN). We determined the prevalence and the factors associated with microalbuminuria among patients with type 2 DM and/or HTN in the urban areas of the Puducherry district in India. We included 225 patients aged 40-69 years with DM and/or HTN from a non-communicable diseases (NCDs) survey conducted during 2019-2020 in the urban areas of Puducherry district. The prevalence of microalbuminuria and various biological risk factors of NCDs were assessed as per the WHO STEPS methodology. The prevalence of microalbuminuria was presented as proportions (95% CI), and the adjusted prevalence ratio (aPR) was estimated using weighted forward stepwise generalized linear modelling. P-value ≤0.05 was considered statistically significant. The mean (SD) age of the patients was 54 (11) years. Over one-third (38.2%) (95% CI: 31.6-44.4) of patients with DM and/or HTN had microalbuminuria. The prevalence was highest among those having both DM and HTN 48% (95% CI: 37-59), followed by those having only DM 40.6% (95% CI: 29-52.2) and only HTN 27.7% (95% CI: 18.1-38.6). The prevalence of microalbuminuria was twice (aPR = 2.1, 95% CI: 1.1-3.9) higher among women and 2.4 times (95% CI: 1.12-5.1) higher among those having both DM and HTN as compared to those with only HTN. The prevalence of microalbuminuria among patients with DM and/or HTN is concerningly high. Population-based screening for microalbuminuria, especially among women and those having both DM and HTN, needs to be undertaken in the urban areas of Puducherry district.

Estimation of Microalbuminuria in Children with Beta Thalassaemia Major: A Cross-sectional Study

Introduction: Improvement in the standard of care of Thalassaemia by regular blood transfusion increases life expectancy. Multiple transfusions with concurrent iron overload and chronic anaemia, leading to tissue-level hypoxemia, cause significant renal dysfunction. Microalbuminuria is a sensitive marker of glomerular damage, and studies in thalassemic children have demonstrated variable prevalence rates of microalbuminuria. Aim: To study the prevalence of microalbuminuria and its association with clinical and laboratory parameters in children with Beta Thalassaemia Major (BTM). Materials and Methods: A cross-sectional study was conducted from January 2018 to June 2019 at Indira Gandhi Institute of Child Health, Bangaluru, Karnataka,India. A total of 155 children with Beta Thalassaemia Major (BTM) aged 2-18 years, attending the Thalassaemia Day Care Centre, were included in the study. Their demographic details such as age, gender, clinical parameters like frequency of transfusions, type of chelation therapy, height, weight, Body Mass Index (BMI), organomegaly, and laboratory parameters like serum creatinine, ferritin, pretransfusion Hb%, and Urinary Microalbumin Creatinine Ratio (UMCR) were studied as per a predesigned proforma. The association between microalbuminuria with clinical and laboratory parameters was evaluated using the independent sample T-test or Mann-Whitney U test and Chi-square/Fischer’s-exact test. Results: A total of 155 children with BTM were studied. In the present study, out of a total of 155 patients, microalbuminuria was found in 66 (42.6%). A significant increase in the prevalence of microalbuminuria was observed as the age advanced, as the frequency of blood transfusions increased, with low pretranfusion haemoglobin (g%), and with elevated serum ferritin. Conclusion: In the present study, the prevalence of microalbuminuria was found to be 42.6%. Screening for microalbuminuria is recommended in all children with beta thalassaemia major for the early detection of renal dysfunction, prevention of disease progression, and improvement in the quality of their lives.

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.

To Estimate the Prevalence of Microalbuminuria and to Determine its Corelation with Left Ventricular Mass Index in Hypertensive Patients - A Cross-Sectional Study

Background: Microalbuminuria (MA) is a sign of renal impairment that can predict cardiovascular disease independently. Left ventricular hypertrophy (LVH) is a prelude to cardiac symptoms of target organ damage in hypertensive patients. Aim: This study aims to determine the relationship between left ventricular mass index (LVMI) and MA in hypertensive patients. Materials and Methods: This cross-sectional study was done from January 2020 to January 2021. In this study, 100 patients aged 18–60 years with hypertension were enrolled. MA was assessed by urine albumin creatinine ratio and LVMI was calculated by two-dimensional echocardiography using the Devereux and Reichek “cube” formula. Results: Mean age was 52.04 ± 9.96 years in study population with male: female of 0.96. The mean systolic blood pressure was 163.80 ± 18.13 mmHg and the mean diastolic blood pressure was 94.90 ± 8.93 mmHg with mean duration of hypertension being 2.49 ± 3.93 years. LVH was present in significant number of patients with MA as compared to those without MA (87.5% vs. 50%, P < 0.001). The LVH was independently associated with MA, albumin-creatinine ratio, and serum creatinine. Out of 77 patients with LVH, 49.4% had high LVMI with a P = 0.002 suggesting a significant correlation between LVH with LVMI. A significant correlation between raised LVMI and presence of MA was seen and the odds of having raised LVMI was 3.46 times in the presence of MA as compared to without MA. Interpretations and Conclusions: This study shows that MA and LVMI are independently correlated, and as a result, MA stands alone as a risk factor for higher cardiovascular morbidity and mortality.

STUDY OF LEFT VENTRICLE MASS AT THE TIME OF DIAGNOSIS IN HYPERTENSIVE PATIENTS

Background: Hypertension is a significant public health issue that affects people all over the world.In India, hypertension affects 5-15 percent of the adult population. In this study we aim at recording incidence of LVH at the time of diagnosis in a tertiary hospital. Aims & Objectives: To monitor Left Ventricular Geometry in newly diagnosed hypertensives, and to study if there is a link between LVH & other indices of target organ damage. Materials & Methods: Hospital based Prospective Analytical study was done in 100 Patients selected by random sampling procedure matching the inclusion criteria. A pretested pro forma was used Follow up was done on inpatient admission and on outpatient department basis. Results: 78 OP & 22 IP patients were studied of which 68 were male and 32 were female LVH was seen in 27% study sample,In the present study, it was observed that there is significant correlation between the prevalence of microalbuminuria and the presence of LVH (P < 0.001) and LV dysfunction (P < 0.002) in hypertensive patients. Hypertensive patients with microalbuminuria were 9.4 times more likely to develop LVH than patients with normal UAE (95% CI: 4.2 - 21.6). ? Conclusion: LVH at the time of diagnosis of hypertension has higher risk of presence of other target organ damages, hence can be used as indicator for prognosis and need for strict monitoring and control of blood pressure recordings with regular follow ups.

Microalbuminuria as the Tip of Iceberg in Type 2 Diabetes Mellitus: Prevalence, Risk Factors, and Associated Diabetic Complications.

Background Microalbuminuria (MA) is an important clinical marker for the early detection of kidney damage in patients with type 2 diabetes (T2DM). Urine albumin-to-creatinine ratio (ACR), also known as urine microalbumin, is a sign of diabetic nephropathy (DN), which is a prevalent complication of diabetes and can result in end-stage renal disease (ESRD) if not managed. The prevalence of MA in T2DM has been steadily increasing worldwide, making it a significant public health concern. The goal of this study was to estimate the prevalence of MA and its relationship to hypertension and other diabetic complications among people with T2DM. Methodology This descriptive cross-sectional study was conducted from February 5, 2022, to February 10, 2023, to analyse data from T2DM patients who visited the outpatient diabetic clinic of Sheikh Zayed Medical College and Hospital, Rahim Yar Khan, Pakistan. This study included a total of 640 patients, aged 35-60 years, who had been diagnosed with T2DM for at least five years and fulfilled the inclusion criteria. Data on demographic and clinical characteristics, blood pressure (BP) measurements, and laboratory investigations were collected. MA was assessed based on the ACR in a spot urine sample of more than 30 mg/l. Blood pressure greater than 140/90 or already taking anti-hypertensives was taken to constitute hypertension. Factors associated with MA like hypertension, gender, mode of diabetes treatment, duration of diabetes, glycosylated haemoglobin (HbA1c), dyslipidemia, and other diabetic complications such as retinopathy and neuropathy were also recorded. Results The prevalence of MA in this study of T2DM patients study was 39.1%. The mean age of the participants with MA was 53.9 with a standard deviation (SD) of 6.1 years, and the mean duration of diabetes was 10.1 years (SD 6.2 years); 101 (33.4%) males (n=302) and 103 (30.5%) females (n=338) had MA. There was a statistically significant correlation between MA > 30mg/d and hypertension (p = <0.001), diabetes duration since diagnosis (p=0.04), HbA1C level (p = <0.001), dyslipidemia (p=0.001), therapy type (p = <0.001), triglyceridemia (p = 0.03), history of diabetes retinopathy (p= <0.002), and peripheral neuropathy (p= <0.001). However, there was no statistically significant correlation between MA and age (p = 0.56), female gender (p = 0.08), low- and high-density lipids, or statin use (p = 0.06). Conclusion The prevalence of microalbuminuria among T2DM patients is significantly high (39.1%) and is positively correlated with various factors such as male gender, hypertension, suboptimal control of diabetes mellitus, high HbA1c levels, longer disease duration, dyslipidemia with high triglycerides,treatment modalities of T2DM, and other diabetic complications like neuropathy and retinopathy. As diabetes is very prevalent in our country, the number of patients with diabetic kidney disease will rise significantly in the near future, leading to ESRD and other diabetic complications, and immediate intervention is needed to prevent this. Further research is warranted to explore potential interventions and evaluate their impact on patient outcomes.

Prevalence of Microalbuminuria in Non-diabetic Hypertensive Patients and its Correlation with Changes in Left Ventricular and Left Atrial Characteristics.

Microalbuminuria is urinary albumin excretion in the range of 30-300 mg per 24 hours and is considered as an abnormal albumin excretion rate. Microalbuminuria is associated with epithelial dysfunction and have a high risk for target organ damage resulting in stroke, retinopathy and adverse cardiovascular events. The objective of the study was to determine the prevalence of microalbuminuria in non-diabetic hypertensive patients and its correlation with cardiovascular changes. A quantitative cross-sectional study was done in 107 participants diagnosed as non-diabetic hypertensive patients visiting to Manmohan Memorial medical college and Teaching hospital and Manmohan Cardio-thoracic Vascular and transplant Centre. The assessed parameters were basic metabolic profile, urine evaluation and Echocardiography. The results showed microalbuminuria in 28 study participants and not seen in 79 participants. Similarly, microalbuminuria was observed more comparable in those with presence of left ventricular hypertrophy as compared to the absence of left ventricular hypertrophy (29.3% versus 22.8%) (p value 0.469); those with presence of left ventricular diastolic dysfunction as compared to the absence of left ventricular diastolic dysfunction (31.1% versus 19%) (p value 0.170) and those with dilated left atrium as compared to normal left atrium (26.7% versus 23.9%) (p value 0.820). In case of left ventricular ejection fraction, those with normal left ventricular ejection fraction (26.3%) had slightly higher proportion of micro-albuminuria than those with mild to moderate left ventricular systolic dysfunction (20%) (p value= 0.755) Conclusions: There was no significant difference in the level of micro-albuminuria between non-diabetics, hypertensive patients with cardio vascular changes compared to patients with no cardiovascular changes.

Microalbuminuria among Patients with Diabetes Mellitus Visiting the Department of Nephrology in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction: Microalbuminuria is an abnormal increase in albumin excretion rate with a specific range of 30-299 mg of albumin/g of creatinine or excretion of 20-200 mg/l of albumin in spot urine samples. Diabetic patients with microalbuminuria are at increased risk for cardiovascular death as compared with normoalbuminuria. The aim of this study was to find out the prevalence of microalbuminuria among patients visiting the Department of Nephrology in a tertiary care centre. Methods: This is a descriptive cross-sectional study conducted among diabetic patients visiting the Department of Nephrology in a tertiary care centre after obtaining ethical approval from the Institutional Review Committee (Reference number: 04072022/04). The study was conducted between 1 October 2022 to 30 November 2022 where patients providing written consent and had documented diabetes were included in the study whereas patients without documented diabetes, having comorbidities such as congestive heart failure, nephritic/nephrotic syndrome and those who refused to give consent were excluded from the study. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 103 patients, microalbuminuria was found to be in 19 (18.45%) (10.96-25.94, 95% Confidence Interval). Out of 19 patients, 8 (42.11%) were male and 11 (57.89%) were female. The mean HbA1c among participants with microalbuminuria was 7.67±0.67%. Conclusions: The prevalence of microalbuminuria among diabetic patients was similar to other studies done in similar settings.

Prevalence of Microalbuminuria Among Diabetes Patients in Africa: A Systematic Review and Meta-Analysis.

Microalbuminuria (MAU) is considered the earliest sign of diabetic nephropathy among diabetes patients. In order to effectively manage diabetic nephropathy and its consequences early, detection of microalbuminuria as soon as possible, especially for diabetes patients, is critical. Therefore, the present study aimed to determine the pooled prevalence of microalbuminuria among diabetes patients in Africa. Electronic databases such as Google Scholar, PubMed, African Journals Online, Web of Science, Cochrane Library, EMBASE, and ResearchGate were searched for articles and grey literature. The STATA version 14 software was used to conduct the meta-analysis. I2 and Cochran's Q test were employed to assess the presence of heterogeneity between studies. Due to the presence of heterogeneity, a random effect model was used. The publication bias was assessed using the symmetry of the funnel plot and Egger's test statistics. Moreover, subgroup analysis, trim and fill analysis, and sensitivity analysis were also done. The overall pooled prevalence of microalbuminuria among diabetes patients in Africa was 37.11% (95% CI 31.27-42.95). Substantial heterogeneity was observed between studies, with I2 values of 94.7%. Moreover, this meta-analysis showed that the pooled estimate of microalbuminuria among type 1 and type 2 diabetes patients was 35.34% (95% CI: 23.89-46.80, I2=94.2), and 40.24% (95% CI: 32.0-48.47, I2=94.9) respectively. MAU, on the other hand, was more common in people with diabetes for more than 5 years 38.73% (95% CI: 29.34-48.13) than in people with diabetes for less than 5 years 31.48% (95% CI: 18.73-44.23). This systematic review and meta-analysis found a high prevalence of microalbuminuria among diabetes patients. As a result, early detection of microalbuminuria is critical for preventing and treating microvascular complications such as diabetic nephropathy and the onset of end-stage renal disease.

Microalbuminuria in Perinatally HIV-Infected Children and Adolescents in the United States.

The kidney is a common target for human immunodeficiency virus (HIV), making renal disease a common noninfectious complication of HIV. Microalbuminuria is an important marker that can detect early renal damage. Timely detection of microalbuminuria is important to initiate renal management and stop the progression of renal dysfunction in people with HIV. Limited data are available about renal abnormalities in people with perinatal HIV infection. The objective of this study was to determine the prevalence of microalbuminuria in a cohort of perinatally HIV-infected children and young adults receiving combination antiretroviral therapy and investigate correlations between microalbuminuria and clinical and laboratory findings. This was a retrospective study of 71 patients with HIV followed in an urban pediatric HIV clinic in Houston, Texas, between October 2007 and August 2016. Demographic, clinical, and laboratory data were compared between subjects with persistent microalbuminuria (PM) and those without. PM is defined as a microalbumin-to-creatinine ratio ≥30 mg/g on at least 2 occasions separated by at least 1 month. Sixteen of 71 patients (23%) met the definition of PM. In univariate analysis, patients with PM had significantly higher CD8+ T-cell activation and lower CD4+ T-cell nadir. Multivariate analysis demonstrated increased microalbuminuria to be independently associated with older age and CD8+ T-cell activation measured as CD8+HLA-DR+ T-cell percentage. Older age and increased activation of CD8+HLA-DR+ on T cells correlate with presence of microalbuminuria in this cohort of HIV-infected patients.

439-P: Microalbuminuria and Hypertension among Indian Patients with Type 2 Diabetes—A Community-Based Cross-Sectional Study

Background and Aims: The India Microalbuminuria Survey (IMS) was a cross-sectional, national survey to understand the prevalence of microalbuminuria (MAU) in Indian hypertensive patients. In the IMS study, 992 patients out of 1369 were diabetic. The objectives of this subset analysis were to estimate the prevalence of microalbuminuria in Indian hypertensives patients with concomitant T2DM. Methods: This cross-sectional subset analysis included 992 diabetic patients visiting a physician’s clinic, from 121 centres across India. Inclusion criteria were male and female outpatients aged ≥ 18years with hypertension and concomitant type II DM and no reason for false positive microalbuminuria reflected in dipstick tests. Exclusion criteria were presence of secondary hypertension and existing CKD. Microalbuminuria was diagnosed if the urinary albumin excretion was more than 30 mg/L using the ACR Kit manufactured by Biosense Technologies Pvt. Ltd. Patient data was analyzed with the help of the SPSS software. Results: The mean age of the patients was 54.04 years. There were 186 (18.75 %) patients below 45 years of age and 806 (81.25%) patients more than 45 years of age. The prevalence of microalbuminuria in hypertensive patients with concomitant type II DM was 31.04 %. The prevalence was 34.4% in patients below 45 years of and 30.27% in patients above 45 years age. Conclusions: This study reports a high prevalence of microalbuminuria in Indian patients with hypertension and concomitant type II DM. Hence, early recognition of renal dysfunction through detection of microalbuminuria and to start treatment without any delay will confer future protection from end stage renal disease as well as hypertension and its complications in type 2 diabetic patients. Disclosure B.Saboo: None. K.Mehta: Employee; JB Chemicals and Pharmaceuticals Ltd. A.Naik: Employee; JB Chemicals and Pharmaceuticals Ltd.