Spot Urine PCR as an Independent Predictor of Renal Disease in Patients with Essential Hypertension

A bstract Background: Hypertension is a global health issue affecting over a billion people, contributing significantly to cardiovascular diseases and chronic kidney diseases (CKD). Proteinuria, detectable using albumin-to-creatinine ratio and spot urine protein-to-creatinine ratio (PCR), serves as an early marker of kidney damage and a predictor of disease progression in hypertensive individuals. Objectives: To evaluate the prevalence and association of proteinuria in patients with essential hypertension, and to determine the effectiveness of spot urine PCR as a predictive marker for assessing the risk of cardiovascular and renal disease. Materials and Methods: A cross-sectional study was conducted at Meenakshi Medical College Hospital with 101 hypertensive patients aged ≥25 years. Proteinuria was assessed using spot urine PCR. Participants underwent clinical and biochemical evaluations, including cholesterol, triglycerides (TG), urea, creatinine, and estimated glomerular filtration rate, using the modification of diet in renal disease equation. Results: The majority of participants were aged 51–60 years (26.7%), with a near-equal gender distribution (50 males; 51 females). The mean age was 54.22 ± 14.45 years for females and 51.96 ± 13.83 years for males ( P = 0.42). The mean body mass index (BMI) was 26.4 ± 2.62 kg/m², with 55.44% classified as pre-obese. Hypertension was prevalent, with 41.5% having systolic blood pressure (SBP) ≥ 140 mm Hg and 33.7% having diastolic blood pressure (DBP) ≥ 90 mm Hg. Laboratory results showed mean total cholesterol of 213.1 ± 26.64 mg/dL and low-density lipoprotein of 149.2 ± 37.72 mg/dL. Proteinuria was categorized as A1 (27.7%), A2 (68.3%), and A3 (4%). Significant positive correlations were found between PCR and TG, blood urea, serum creatinine, and both SBP and DBP ( P < 0.0001). Conclusion: This study confirms a significant association between hypertension and proteinuria, with age, BMI, and blood pressure playing crucial roles in renal dysfunction. Spot urine PCR proved to be an effective and cost-efficient tool for early detection of kidney impairment in hypertensive patients. The findings highlight the importance of managing hypertension and obesity to prevent CKD progression.