Key result
Among patients with type 2 diabetes, the prevalence of micro- and macroalbuminuria was 14.2% and 5.7%, respectively, with hypertension significantly increasing the odds of albuminuria (OR 3.47).
Cross-Sectional (n=786)
No
Using a more stringent two-test quantitative criteria, the prevalence of microalbuminuria in Singaporean primary care T2DM patients is 14.2%, significantly lower than previously reported, likely reflecting better diagnostic accuracy and high baseline use of renin-angiotensin system inhibitors.
Lower albuminuria prevalence in T2DM with stringent criteria is hypothesis-generating; leaves open prospective validation of hypertension association.
INTRODUCTION: Microalbuminuria is an early sign of kidney damage. The prevalence of microalbuminuria in Singapore has been reported to be 36.0%-48.5%. However, the prevalence of microalbuminuria reported in these studies was determined with one urine sample using a qualitative urine test. The aim of this study was to determine the prevalence of micro- and macroalbuminuria using a more stringent criterion of two positive quantitative urine albumin-creatinine ratio (ACR) tests. METHODS: We conducted a cross-sectional study of patients with type 2 diabetes mellitus (T2DM) who were followed up at a primary care clinic in Singapore. Patients were diagnosed to have albuminuria if they had two positive ACR tests within a seven-month period. RESULTS: A total of 786 patients with T2DM met the study's inclusion criteria. 55.7% were already on an angiotensin-converting enzyme inhibitor (ACEI) and/or angiotensin receptor blocker (ARB). The prevalence rates of micro- and macroalbuminuria were 14.2% and 5.7%, respectively. Patients with albuminuria were more likely to have hypertension (odds ratio [OR] 3.47, 95% confidence interval [CI] 1.55-7.80). Diabetics with poorer diabetic control (OR 1.88, 95% CI 1.26-2.79), and higher systolic (OR 1.69, 95% CI 1.14-2.49) and diastolic (OR 1.96, 95% CI, 1.20 to 3.22) blood pressures were more likely to have albuminuria. CONCLUSION: In the present study, the prevalence of microalbuminuria is significantly lower than that previously reported in Singapore. The presence of hypertension, poor diabetic control and suboptimal blood pressure control are possible risk factors for albuminuria in patients with T2DM.
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Lee et al. (2015) conducted a cross-sectional in Type 2 diabetes mellitus (n=786). Hypertension vs. No hypertension was evaluated on Albuminuria (OR 3.47, 95% CI 1.55-7.80, p=0.003). Among patients with type 2 diabetes, the prevalence of micro- and macroalbuminuria was 14.2% and 5.7%, respectively, with hypertension significantly increasing the odds of albuminuria (OR 3.47).
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