The prevalence of albuminuria among diabetic patients in a primary care setting in Singapore

Abstract

INTRODUCTIONMicroalbuminuria is an early sign of kidney damage. The prevalence of microalbuminuria in Singapore has been reported to be 36.0%-48.5%. However, the prevalence of microalbuminuria reported in these studies was determined with one urine sample using a qualitative urine test. The aim of this study was to determine the prevalence of micro-and macroalbuminuria using a more stringent criterion of two positive quantitative urine albumin-creatinine ratio (ACR) tests. METHODSWe conducted a cross-sectional study of patients with type 2 diabetes mellitus (T2DM) who were followed up at a primary care clinic in Singapore. Patients were diagnosed to have albuminuria if they had two positive ACR tests within a seven-month period. RESULTSA total of 786 patients with T2DM met the study's inclusion criteria. 55.7% were already on an angiotensin-converting enzyme inhibitor (ACEI) and/or angiotensin receptor blocker (ARB). The prevalence rates of micro-and macroalbuminuria were 14.2% and 5.7%, respectively. Patients with albuminuria were more likely to have hypertension (odds ratio [OR] 3.47, 95% confidence interval [CI] 1.55-7.80). Diabetics with poorer diabetic control (OR 1.88, 95% CI 1.26-2.79), and higher systolic (OR 1.69, 95% CI 1.14-2.49) and diastolic (OR 1.96, 95% CI, 1.20 to 3.22) blood pressures were more likely to have albuminuria. CONCLUSIONIn the present study, the prevalence of microalbuminuria is significantly lower than that previously reported in Singapore. The presence of hypertension, poor diabetic control and suboptimal blood pressure control are possible risk factors for albuminuria in patients with T2DM.

Prevalence, Characteristics and Predictive Factors of Microalbuminuria in Resistant Systemic Arterial Hypertension

“…The prevalence of MAU increased to 74% in the presence of more than 3 comorbidities [31][32][33]. The present study confirms previous trials that have demonstrated a strong relationship between MAU and the level of systolic BP [5,6]. Most of our RH patients had severe, second and third degree hypertension, with high CV risk.…”

“…It was demonstrated that MAU is a marker of endothelial dysfunction that predicts a greater incidence of target organ damage, cardio-and cerebrovascular events and that its reduction lowers these comorbidities [5]. The reported prevalence of MAU is highly variable among studied populations, ranging from 7% to 58.4% [6,7]. This variation can be explained by differences in population characteristics, investigation methods and prescribed drugs [8 -10].…”

Determination of Microalbuminuraia and Its Relation to HTN in Type 2 Diabetic Patients and General People

“…No significant association was found between two groups regarding TC, TG, HDL and LDL. A study conducted in china also found similar result [50].…”

Association Between Routine Nephropathy Monitoring and Subsequent Change in Estimated Glomerular Filtration Rate in Patients With Diabetes Mellitus: A Japanese Non-Elderly Cohort Study

“…Furthermore, the population who might potentially benefit from nephropathy monitoring is quite small; among Asian people with diabetes mellitus, only 0.9% had albuminuria and normal blood pressure. 24 This small fraction of the population may have made it difficult to detect any positive effect of nephropathy monitoring on subsequent change in outcomes, even in our analysis restricted to normotensive individuals with diabetes mellitus. Another possible explanation for our findings is that intensive control of diabetes mellitus and hypertension is still difficult, even when physicians detect signs of renal function impairment, because intensive glycemic and blood pressure control require the patient's recognition of the disease and implementation of lifestyle changes.…”