Microalbuminuria independently predicts higher risk of renal and cardiovascular complications in patients with primary hypertension but without diabetes, according to research published online April 29 in the Clinical Journal of the American Society of Nephrology.
Francesca Viazzi, M.D., of the University of Genoa in Italy, and colleagues conducted a study of 917 patients with hypertension and without diabetes at baseline, following them for a median of 11.8 years. Urinary albumin-to-creatinine ratio (ACR) was used to determine microalbuminuria based on gender-specific cut-points (ACR of at least 22 mg/g in men and at least 31 mg/g in women).
The researchers found that microalbuminuria at baseline was associated with an increased risk for developing chronic renal insufficiency (relative risk [RR], 7.61), as well as cardiovascular events (composite of fatal and nonfatal cardiac and cerebrovascular events; RR, 2.11), and cardiorenal events (composite of former end points; RR 3.21).
After adjustment for baseline covariates, microalbuminuria was still significantly associated with cardiorenal events (RR, 2.58) and chronic renal insufficiency (RR, 12.75).
“Patients with microalbuminuria should be aggressively targeted for renal and cardiovascular risk factor reduction, although further research is warranted to determine whether specific treatment would help to improve outcomes, as already reported for patients with diabetes,” the authors write.
Francesca Viazzi, Giovanna Leoncini, Novella Conti, Cinzia Tomolillo, Giovanna Giachero, Marina Vercelli, Giacomo Deferrari, and Roberto Pontremoli
* Department of Cardionephrology and Department of Internal Medicine, University of Genoa, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy; Registro Tumori della Regione Liguria, SS Epidemiologia Descrittiva, IST-Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; and DISSAL Dipartimento Scienze della Salute, Universit?? di Genova, Genoa, Italy
Published ahead of print on April 29, 2010
Clinical Journal of the American Society of Nephrology