Urinary Protein Excretion Is Associated with Left Ventricular Hypertrophy in Treatment-Naïve Hypertensive Patients in an African Hospital Setting

Forlemu, Arnold; Menanga, Alain; Ashuntantang, Gloria; Kingué, Samuel

doi:10.1159/000349938

Cited by 9 publications

(9 citation statements)

References 34 publications

(36 reference statements)

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“…Numerous studies have investigated the use of the spot urine P/C ratio for the quantitative assessment of proteinuria not only in kidney disease but also in other disease states that are accompanied by proteinuria [1,[7][8][9][10][11][12][13].…”

Section: Proteinuria Evaluationmentioning

confidence: 99%

Diagnostic utility of protein to creatinine ratio (P/C ratio) in spot urine sample within routine clinical practice

Kamińska

Dymicka-Piekarska

Tomaszewska

et al. 2020

Critical Reviews in Clinical Laboratory Sciences

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The spot (random) urine protein to creatinine ratio (P/C ratio) is an alternative, fast and simple method of detecting and estimating the quantitative assessment of proteinuria. The aim of the work was to review the literature concerning the usefulness of spot urine P/C ratio evaluation in the diagnosis of proteinuria in the course of kidney disease, hypertension, gestational hypertension, preeclampsia, immunological diseases, diabetes mellitus, and multiple myeloma, and in the diagnosis of proteinuria in children. We searched the PubMed and Google Scholar databases using the following keywords: proteinuria, spot urine protein to creatinine ratio, spot urine P/C ratio, protein creatinine index, PCR (protein to creatinine ratio), P/C ratio and methods, Jaffe versus enzymatic creatinine methods, urine protein methods, spot urine protein to creatinine ratio versus ACR (albumin to creatinine ratio), proteinuria versus albuminuria, limitations of the P/C ratio. More weight was given to the articles published in the last 10-20 years. A spot urine P/C ratio >20 mg/mmol (0.2 mg/mg) is the most commonly reported cutoff value for detecting proteinuria, while a P/C ratio value >350 mg/mmol (3.5 mg/mg) confirms nephrotic proteinuria. The International Society for the Study of Hypertension in Pregnancy recommends a P/C ratio of 30 mg/mmol (0.3 mg/mg) for the classification of proteinuria in pregnant women at risk of preeclampsia. A high degree of correlation was observed between P/C ratio values and the protein concentration in 24-h urine collections. The spot urine P/C ratio is a quick and reliable test that can eliminate the need for a daily 24-h urine collection. However, in doubtful situations, it is still recommended to assess proteinuria in a 24-h urine collection. The literature review indicates the usefulness of the spot P/C ratio in various disease states; therefore, this test should be available in every laboratory. However, the challenge for the primary care physician is to know the limitations of the methods used to determine the protein and creatinine concentrations that are used to calculate the P/C ratio. Moreover, the P/C ratio cutoff used should be determined in individual laboratories because it depends on the patient population and the laboratory methodologies.

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Section: Proteinuria Evaluationmentioning

confidence: 99%

Diagnostic utility of protein to creatinine ratio (P/C ratio) in spot urine sample within routine clinical practice

Kamińska

Dymicka-Piekarska

Tomaszewska

et al. 2020

Critical Reviews in Clinical Laboratory Sciences

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“…8 Uncontrolled hypertension leads to heart attack, stroke, kidney disease or failure, vision loss, sexual dysfunction, and peripheral arterial disease (PAD). 8 Hypertension induced organ damage is manifested by elevations in albumin excretion (proteinuria), 9 and left ventricular hypertrophy and presence of left ventricular strain pattern in ECG. 10 Moreover, detection of hard exudates, cotton wool spots, papilledema, retinal hemorrhages, and microaneurysms in fundoscopy, and presence of ischaemic or hemorrhagic brain injury in brain imaging by computed tomography (CT) are other manifestations of hypertension induced end organ damage.…”

Section: Introductionmentioning

confidence: 99%

<p>Hypertension and Its Associated Factors Among Type 2 Diabetes Mellitus Patients at Debre Tabor General Hospital, Northwest Ethiopia</p>

Akalu¹,

Belsti²

2020

DMSO

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Background: Type 2 diabetes mellitus (T2DM) is associated with a high risk of early mortality and morbidity from hypertension. Even though Ethiopia is Africa's first country among the top five in the prevalence of DM, there is a paucity of data on hypertension and its associated factors among patients with type 2 diabetes mellitus. Therefore, this study aimed to determine the prevalence and associated factors of hypertension among type 2 diabetes mellitus patients at Debre Tabor General Hospital, 2019. Methods and Materials: An institution-based cross-sectional study was employed on 378 T2DM patients. Data were collected using an interviewer-administered questionnaire and analyzed by Stata 14. A multivariable logistic regression model was used to identify associated factors of hypertension among T2DM patients. Associated factors were declared at p < 0.05. Results: The prevalence of hypertension among T2DM patients was 59.5% (95% CI: 54.5-64.5). Stage 1 hypertension was the most common (30.95%). The odds of hypertension was higher among age group of 50-60 years (adjusted odds ratio (AOR)=2.5, 95% confidence interval (CI) (1.27-4.90)), patients from urban area (AOR = 2.8, 95% CI (1.08-7.18)), with longer duration of T2DM (AOR =1.16, 95% CI (1.08-1.25)), with BMI ≥25 kg/ m 2 (AOR = 3.2, 95% CI (1.71-5.96)), with poor glycemic control (AOR = 3.0, 95% CI (1.75-5.19)), and patients who were current cigarette smokers (AOR = 3.8, 95% CI (1.98-14.96)). Conclusion:The prevalence of hypertension is high and the majority have poor blood pressure control. Hence, DM care providers and other health sector stakeholders have to work in collaboration to prevent it through designing appropriate strategies especially for those at higher risk of developing hypertension.

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“…(23)(24) According to Forlemu et al (2013), Urinary Protein Excretion Is Associated with left ventricular hypertrophy in untreated hypertensive patients in an African Hospital Setting. (9) Saitoh M et al (1998) noted that the incidences of proteinuria and advanced retinal vascular change were higher in patients with left ventricular hypertrophy than in those without left ventricular hypertrophy and concluded that proteinuria is related to elevated left ventricular mass in patients with essential hypertension. (25) According to estimates from Framingham study, Sheshadri et al concluded that blood pressure is significant determinant for life time risk of stroke.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2017

IOSR JDMS

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Introduction: Hypertension is common disorder and leading cause of morbidity and mortality worldwide. Proteinuria has recently been identified as a cardiovascular risk marker in hypertensive patients. In this view left ventricular hypertrophy was studied with reference to hypertension and 24 hours proteinuria. Aims: To study left ventricular hypertrophy, 24 hours proteinuria and their co-relation in hypertensive subjects. Material and methods: The study was cross sectional type including 100 hypertensive subjects attending medicine department. The hypertensives with renal disease, ischaemic heart disease excluded from the study. Esbach's method to estimate 24 hour urine protein was used. Left ventricular hypertrophy(LVH) was determined by 2-D echo using Devereux formula. Statistical analysis was done.Result: Mean Proteinuria for the duration of hypertension ≤5 years was 0.27±0.13 and for the duration of >5 years it was 0.44±0.14(z-value=6.04,p-value =0.000).Mean LVH for the duration of hypertension ≤5 yr was 118.55±31.81 and for the duration of >5 years it was 231.74±53.71(z-value=3.87,p-value =0.000).Significant positive co-relation was found between proteinuria and LVH(r=0.350, p-value=0.000 and Mean ±2SD of correlation of 0.012 to 0.392) which means that as LVH increases proteinuria also increases significantly. Conclusion: Hypertensive subjects develop proteinuria. As duration of hypertension increases, left ventricular hypertrophy and proteinuria also increases.

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Urinary Protein Excretion Is Associated with Left Ventricular Hypertrophy in Treatment-Naïve Hypertensive Patients in an African Hospital Setting

Cited by 9 publications

References 34 publications

Diagnostic utility of protein to creatinine ratio (P/C ratio) in spot urine sample within routine clinical practice

Diagnostic utility of protein to creatinine ratio (P/C ratio) in spot urine sample within routine clinical practice

<p>Hypertension and Its Associated Factors Among Type 2 Diabetes Mellitus Patients at Debre Tabor General Hospital, Northwest Ethiopia</p>

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