Microalbuminuria as a Target to Improve Cardiovascular and Renal Outcomes

Basi, Seema; Lewis, Julia B.

doi:10.1053/j.ajkd.2006.02.182

Cited by 79 publications

(61 citation statements)

References 99 publications

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“…It is interesting that start of antihypertensive medication was selected even though the model was adjusted for change in BP. This suggests that start of antihypertensive drugs may have a UAE-lowering effect that is unrelated to the simultaneous lowering of BP, as has been suggested of ACEi and ARB (35)(36)(37). Notably, Ͼ50% of start of antihypertensive drugs was due to start of an ACEi or ARB.…”

Section: Discussionmentioning

confidence: 89%

What Predicts Progression and Regression of Urinary Albumin Excretion in the Nondiabetic Population?

Brantsma¹,

Atthobari²,

Bakker³

et al. 2007

Journal of the American Society of Nephrology

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Section: Discussionmentioning

confidence: 89%

What Predicts Progression and Regression of Urinary Albumin Excretion in the Nondiabetic Population?

Brantsma¹,

Atthobari²,

Bakker³

et al. 2007

Journal of the American Society of Nephrology

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“…[12][13][14][15][16][17] Indeed, some authors have even advocated screening for microalbuminuria and using it as a therapeutic target for identification and treatment of patients at increased risk for future cardiovascular disease. [18][19][20] The association between cardiovascular risk factors and microalbuminuria in children is unclear, and previous studies came to seemingly discrepant conclusions. Studies with referral-based populations of overweight adolescents found that cardiovascular risk factors increased the risk for microalbuminuria, [21][22][23] similar to findings observed among adults.…”

Section: Introductionmentioning

confidence: 96%

Being Overweight Modifies the Association Between Cardiovascular Risk Factors and Microalbuminuria in Adolescents

et al. 2008

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OBJECTIVE-The goal was to determine the association between cardiovascular risk factors and microalbuminuria in a nationally representative sample of adolescents and to determine whether being overweight modifies this association. METHODS-We analyzed cross-sectional data from the National Health and NutritionExamination Survey(1999Survey( -2004 for 2515 adolescents 12 to 19 years of age. Cardiovascular risk factors included abdominal obesity, impaired fasting glucose, diabetes mellitus, insulin resistance, high triglyceride levels, low high-density lipoprotein cholesterol levels, hypertension, smoking, and the metabolic syndrome. Microalbuminuria was defined as a urinary albumin/creatinine ratio of 30 to 299 mg/g in a random morning sample. Overweight was defined as BMI of ≥95th percentile, according to the Centers for Disease Control and Prevention 2000 growth charts.RESULTS-Microalbuminuria was present in 8.9% of adolescents. The prevalence of microalbuminuria was higher among nonoverweight adolescents than among overweight adolescents. The median albumin/creatinine ratio decreased with increasing BMI z scores. The association of microalbuminuria with cardiovascular risk factors differed according to BMI category. Among nonoverweight adolescents, microalbuminuria was not associated with any cardiovascular disease risk factor except for overt diabetes mellitus. Among overweight adolescents, however, microalbuminuria was associated with impaired fasting glucose, insulin resistance, hypertension, and smoking, as well as diabetes mellitus.CONCLUSION-For the majority of adolescents, microalbuminuria is not associated with cardiovascular risk factors. Among overweight adolescents, however, microalbuminuria is associated with cardiovascular risk factors. The prognostic importance of microalbuminuria in overweight and nonoverweight adolescents with regard to future cardiovascular and renal disease needs to be defined in prospective studies conducted specifically in children. Copyright © 2008 by the American Academy of PediatricsAddress correspondence to Stephanie Nguyen, MD, UCSF Children's Renal Center, 533 Parnassus Ave, Box 0748, San Francisco, CA 94131-0748. nguyens@peds.ucsf.edu. The authors have indicated they have no financial relationships relevant to this article to disclose. This trial has been registered at www.clinicaltrials.gov (identifier 2006-3594 The prevalence of childhood obesity has tripled since the middle 1980s and continues to increase. 1,2 Overweight children and adolescents are thought to be at greater risk for earlier onset of cardiovascular and renal diseases in adulthood, which represents a major public health concern. 3 Obesity and its metabolic consequences lead to endothelial dysfunction and cardiovascular disease. 4 Increased urinary albumin excretion (microalbuminuria) is a marker of endothelial dysfunction and reflects renal and systemic endovascular damage. 5-7 Microalbuminuria, which was originally used to predict the development of overt diabetic nephropathy in patients with...

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“…[11] Microalbuminuria is a hallmark of Diabetic Nephropathy [13] and studies have shown that reduction of this parameter improves cardiovascular and renal outcomes, not only in diabetics but also in non-diabetics. [14,15] than ACEI's (enalapril/ ramipril/ lisinopril). Both classes of drugs are reducing microalbuminuria but ARB's are found to be more effective than ACEI's.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy of Arb’s and Acei’s in Treatment of Microalbuminuria With Type Ii Diabetes

Kishore¹

2017

WJPPS

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Microalbuminuria is the condition where increase of albumin protein excretion in the urine ranges from 30-299 mg/day. Hypertension and diabetes are the biggest risk factors and type II DM is the most common one. Albuminuria is a powerful predictor of renal and cardiovascular risk. The aim of the study was to compare the effect of ARB's and ACEI's in treatment of microalbuminuria with type II DM and hypertension. This mixed cohort study has been conducted at a private diabetic clinic located at Hanamkonda, Warangal, and Telangana, India. We have included the patients of type II DM and hypertension with microalbuminuria. A total of 180 patients data have collected during the study period (January 2016 -June2016). Among them 150 patients data was included and divided into two groups. Patients who were prescribed with ACEI's and ARB's were categorised into group I and group II respectively. The results have showed that micro albuminuria in group I, before starting ACEI's therapy was 74.57 ± 50.43 and after therapy was 54.32 ± 46.37 and in group II before starting ARB's therapy was 72.64 ± 51.96 and after therapy was 50.66 ± 44.62. This study showed that both ACEI's and ARB's have renal protection and ARB's (telmisartan/ olmesartan/ losartan) have reduced microalbuminuria levels more than ACEI's.

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Microalbuminuria as a Target to Improve Cardiovascular and Renal Outcomes

Cited by 79 publications

References 99 publications

What Predicts Progression and Regression of Urinary Albumin Excretion in the Nondiabetic Population?

What Predicts Progression and Regression of Urinary Albumin Excretion in the Nondiabetic Population?

Being Overweight Modifies the Association Between Cardiovascular Risk Factors and Microalbuminuria in Adolescents

Comparison of Efficacy of Arb’s and Acei’s in Treatment of Microalbuminuria With Type Ii Diabetes

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