Determination of Microalbuminuraia and Its Relation to HTN in Type 2 Diabetic Patients and General People
European Journal of Preventive Medicine
Volume 7, Issue 6, December 2019, Pages: 117-122
Received: Oct. 23, 2019;
Accepted: Nov. 12, 2019;
Published: Nov. 26, 2019
Views 194 Downloads 67
Nowshin Monir, Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
Zebunnesa Zeba, Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
Sharmin Sultana, Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
Ijajul Islam, Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
Background: Microalbuminuria is a clinical marker of glomerular injury and identified as a risk of progressive renal damage, cardiovascular disease and morbidity. Hypertension (HTN) is a worldwide public health problem andcommonly coexists with Diabetes Mellitus (DM). Objective: The aim of the study was todetermine the prevalence of microalbuminuriain type 2diabetic patients and general people and the relationship between microalbuminuria withHTN and other clinical parametersin these twogroups of people. Methodology: A cross-sectional study was carried out using a pretested structured questionnaire amongrandomly selected107 participants aged from 35-70 years. Out of 107 participants 64 persons were type 2 diabetic patients and 43 were healthy individuals. Biochemical analysis of blood and urine samples was performed. Result: The prevalence of microalbuminuria was 17.2% in diabetic patients and 25.6% ingeneral people whereas the prevalence of HTN was 48.4% among diabetic patients and 51.6% in normal healthy persons. Regardless of the group considered, when microalbuminuria was analyzed according to the different clinical parameters, microalbuminuricpatients had significantly highersystolic (p=0.03) diastolic (p=0.02) blood pressure, urine creatinine (p=0.000), serum creatinine (p=0.012), urine albumin (p=0.019) and GFR (p=0.000). Microalbuminuria was found to be associated with HTN (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.2-9.7). Conclusion: The study concluded thatmicroalbuminuria prevalence is high among general people and HTN has a significant relationship with microalbuminuria. These findings suggest early screening of microalbuminuria and the proper management of other clinical parameters to halt and prevent end stage renal disease and cardiovascular risk in future.
Determination of Microalbuminuraia and Its Relation to HTN in Type 2 Diabetic Patients and General People, European Journal of Preventive Medicine.
Vol. 7, No. 6,
2019, pp. 117-122.
National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002; 39: 1–266.
Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: 1105–87.
Parving HH, Oxenboll B, Svendsen PA, Christiansen JS, Andersen AR. Early detection of patients at risk of developing diabetic nephropathy. A longitudinal study of urinary albumin excretion. ActaEndocrinol (Copenh) 1982; 100: 550-5.
Viberti GC, Hill RD, Jarrett RJ, Argyropoulos A, Mahmud U, Keen H. Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. The Lancet 1982; 1: 1430–2.
Haneda M, Kikkawa R, Togawa M, Koya D, Kajiwara N, Uzu T. High blood pressure is a risk factor for the development of microalbuminuria in Japanese subjects with non-insulin-dependent diabetes mellitus. J Diabetes Complications 1992; 6: 181–5.
Wachtell K, Ibsen H, Olsen MH, Borch-Johnsen K, Lindholm LH, Mogensen CE. Albuminuria and cardiovascular risk in hypertensivepatients with left ventricular hypertrophy: the LIFE study. Ann Intern Med 2003; 139: 901–6.
Forman JP, Brenner BM. ‘Hypertension’ and ‘microalbuminuria’: the bell tolls for thee. Kidney Int 2006; 69: 22–8.
Choi HS, Sung KC, Lee KB. The prevalence and risk factors of microalbuminuria in normoglycemic, normotensive adults. ClinNephrol 2006; 65: 256–61.
Konta T, Hao Z, Abiko H, Ishikawa M, Takahashi T, Ikeda A. Prevalence and risk factor analysis of microalbuminuria in Japanese general population: the Takahata study. Kidney Int 2006; 70: 751–6.
Dixon A, Raymond N, Mughal S, Rahim A, O'Hare JP, Kumar S, Barnett A. Prevalence of microalbuminuria and hypertension in South Asians and white Europeans with type 2 diabetes: a report from the United Kingdom Asian Diabetes Study (UKADS). Diab and Vasc Dis Res 2006; 3: 22-5.
Summerson J, Bell R, Konen J. Racial differences in the prevalence of microalbuminuria in hypertension. Am J Kidney Dis 1995; 26: 577-9.
Varghese A, Deepa R, Rema M, Mohan V. (2001). Prevalence of microalbuminuria in type 2 diabetes mellitus at a diabetes centre in southern India. Postgrad Med J 2001; 77: 399–402.
Lawes CM, Rodgers A, Bennett DA, Parag V, Suh I, Ueshima H. Blood pressure and cardiovascular disease in the Asia Pacific region. J Hypertens 2003; 21: 707–16.
Romundstad S, Holmen J, Hallan H, Kvenild K, Ellekjaer H. Microalbuminuria and all-cause mortality in treated hypertensive individuals: does sex matter? The Nord-Trondelag Health Study (HUNT), Norway. Circulation 2003; 108: 2783–9.
Giaconi S, Levanti C, Fommei E, Innocenti F, Seghieri G, Palla L. Microalbuminuria and casual and ambulatory blood pressure monitoring in normotensives and in patients with borderline and mild essential hypertension. Am J Hypertens 1989; 2: 259–61.
Gerber LM, Shmukler C, Alderman MH. Differences in urinary albumin excretion rate between normotensive and hypertensive, white and nonwhite subjects. Arch Intern Med 1992; 152: 373–7.
Parving HH, Mogensen CE, Jensen HA, Evrin PE. Increased urinary albumin-excretion rate in benign essential hypertension. The Lancet 1974; 1: 1190–2.
Bianchi S, Bigazzi R, Baldari G, Campese VM. Microalbuminuria in patients with essential hypertension: Effects of several antihypertensive drugs. Am J Med 1992; 93: 525-8.
Verdecchia P, Reboldi GP. Hypertension and microalbuminuria: The new detrimental duo. Blood Press 2004; 13: 198-211.
Bakari AG, Narayan D. Diabetes mellitus Complicating B-Thalassemia: A case. Annals of African medicine 2003; 2: 36-8.
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet. 2012; 380: 2163-96.
Melmed s, Polonsky k, Larsen PR, Henry K. Williams textbook of endocrinology. 12 ed. Elsevier/Saunders; 2011.
Shi Y, Hu FB. The global implications of diabetes and cancer. The Lancet. 2014; 383: 1947-8.
Parving HH, Lehnert H, Bröchner-Mortensen J, Gomis R, Andersen S, Arner P. Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria Study Group. The effect ofirbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. New Engl J Med 2001; 345: 870-8.
Dodson PM. Hypertension and diabetes. Curr Med Res Opin 2002; 18: 48-57.
Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Himmelfarb CD, De Palma SM. 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. J Am Coll Cardiol 2017; 4.
Wrone EM, Carnethon MR, Panaliappan LP, et al. Association of dietary protein intake and microalbuminuria in healthy adults: Third National Health and Nutrition Examination Survey. Am J Kid Dis 2003; 41: 580-7.
Akter S, Rahman MM, Abe SK, Sultana P. Prevalence of diabetes and prediabetes and their risk factors among Bangladeshi adults: a nationwide survey. Bulletin of the World Health Organization 2014; 92: 204-13.
Ann DC, Roberto P, and Shahnaz K. Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review. Diabetes Metab Syndr Obes 2013; 6: 327–38.
World Health Organization. Global Health Observatory (GHO) data. Raised blood pressure.
Vijeth SB, Girish I. Nandini HV. A cross sectional study to assess the prevalence of microalbuminuria in patients with type 2 diabetes mellitus. Int J Res Med Sci 2018; 6: 117-20.
Ahmedani MY, Hydrie MZI, Iqbal A, Gul A, Mirza WB, Basit. A Prevalence of Microalbuminuria in Type 2 Diabetic Patients in Karachi: Pakistan A Multi-center Study. J Pak Med Assoc 2005; 55: 382-6.
Marshall SM, Alberti KGMM. Comparison of the prevalence and associated features of abnormal albumin excretion in insulindependent and non-insulin-dependent diabetes. Q J Med. 1989; 70: 61–71.
Amos AF, McCarty DJ, Zimmet P. The rising global burden of diabetes and its complications. Diabet Med 1997; 14: 1-85.
Haffner SM, Morales PA, Gruber MK, et al. Cardiovascular risk factors in non-insulin dependent diabetic subjects with microalbuminuria. Arterioscler Thromb. 1993; 13: 205–10.
Nelson RG, Kunzelman CL, Pettit DJ, et al. Albuminuria in type 2 (non-insulindependent) diabetes mellitus and impaired glucose tolerance in Pima Indians. Diabetologia. 1989; 32: 870–6.
Hamman RF, Franklin GA, Mayer EJ, et al. Microvascular complication of NIDDM in Hispanics and non-Hispanic whites. Diabetes Care. 1991; 14: 655–63.
Jones CA, Francis ME, Eberhardt M, et al. Microalbuminuria in the US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2002; 39: 445–59.
Atkins RC, Polkinghorne KR, Briganti EM, et al. Prevalence of albuminuria in Australia. Aus Diab Kidney Int 2004; 66 (S92): S22–4.
Hillege HL, Fidler V, Diercks GF, et al. Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population. Circulation 2002; 106: 1777–82.
Zacharias JM, Young TK, Riediger ND, et al. Prevalence, risk factors and awareness of albuminuria on a Canadian First Nation: a community-based screening study. BMC Public Health 2012; 12: 290.
Sabanayagam C, Shankar A, Saw SM, et al. Socioeconomic status and microalbuminuria in an Asian population. Nephrol Dial Transplant 2009; 24: 123–9.
Koroshi A. Microalbuminuria, is it so important? HIPPOKRATIA 2007, 11, 3: 105-7.
Susztak k, Sharma K, Schiffer M, McCue P, Ciccone E, Böttinger PE. Genomic strategies for diabetic nephropathy. J Am Society of Nephrol 2003; 14: 271-8.
Mogensen CE, Poulsen PL. Epidemiology of microalbuminuria in diabetes and in the background population. CurrOpin in Nephrol and Hypertens 1994; 3: 248–56.
Ali A, Taj A, Amin MJ, Iqbal F, Iqbal Z. Correlation between microalbuminuria and hypertension in Type 2 diabetic patients. Pak J Med Sci 2014; 30: 511-4.
Shin KE, Roh YK, Cho KH, Han KD, Park YG, Kim DH, Kim YH. The prevalence of hypertension in relation with the normal albuminuria range in type 2 diabetes mellitus within the South Korean population: The Korean National Health and Nutrition Examination Survey, 2011–2012. Prim Care Diab 2017; 11: 281-7.
Yan L, Ma J, Guo X, Tang J, Zhang J, Lu Z, Wang H, Cai X, Wang L. Urinary albumin excretion and prevalence of microalbuminuria in a general Chinese population: a cross-sectional study. MC Nephrology 2014, 15: 165.
Altibi HI. Microalbuminuria among Type 2 Diabetic Patients in the Gaza Strip. Thesis paper 2007.
Lee ES, Tang WE. The prevalence of albuminuria among diabetic patients in a primary care setting in Singapore. Singapore Med J 2015; 56: 681-6.