January 24, 2014Open Access

The prevalence, characteristics and clinical significance of abnormal albuminuria in patients with hypertension

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Essential hypertension (n=350). Primary outcome: Prevalence of abnormal albuminuria (≥30 mg/g Cr).

Key Result

In hypertensive outpatients, the prevalence of abnormal albuminuria was 35.4%, and its presence was independently correlated with systolic blood pressure, B-type natriuretic peptide, and C-reactive protein.

Study Design

Type

Cross-Sectional (n=350)

Multicenter

PICO

Population

Essential hypertension (n=350)

Primary Outcome

Prevalence of abnormal albuminuria (≥30 mg/g Cr)

Limitations

The cross-sectional nature of the study design limits the ability to determine causal relationships between urinary albumin and associated factors.
The study cohort may have different age, severity, and duration of hypertension compared to previously studied populations, potentially affecting the generalizability of the prevalence rate.

Abstract

Kidney function and cardiovascular disease are closely connected and albuminuria is a proven marker of cardiovascular risk. The present study investigated the prevalence and characteristics of albuminuria in patients with hypertension. Outpatients with essential hypertension under medical treatment were enrolled in this study (n = 350, 70.0 ± 11.4 years old). Urine samples were collected for the measurement of albumin concentration, which are expressed as the ratio of urine albumin to creatinine concentration (mg/g Cr). Cross-sectional analyses were also performed of the relationships between urinary albumin and other variables. Urinary albumin was detected in 88.3% of patients, while only 35.4% showed abnormal albuminuria (≥30 mg/g Cr). The presence of abnormal albuminuria was independently correlated with systolic blood pressure, B-type natriuretic peptide and C-reactive protein by multivariate analysis (P < 0.05). Furthermore, multivariate regression analysis identified systolic blood pressure, serum creatinine, B-type natriuretic peptide and C-reactive protein as the only factors showing independent correlation with urinary albumin (P < 0.05). Thus, approximately 35% of hypertensive patients had abnormal albuminuria. Urinary albumin was closely associated with blood pressure, C-reactive protein and B-type natriuretic peptide, indicating that the severity of albuminuria parallels that of systemic inflammation, cardiac load and blood pressure.

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