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 2023 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.