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RESEARCH PRODUCT
Urinary albumin excretion and glomerular filtration rate across the spectrum of glucose abnormalities in essential hypertension.
Pilar RodríguezAlberto GalgoClaudia FilozofMiguel ÁNgel BritoJose V. LozanoRafael MarínJavier MediavillaSalvador TrancheFrancisco J. Morales-olivasRedon Josepsubject
Malemedicine.medical_specialtyRenal functionType 2 diabetesEssential hypertensionGastroenterologyExcretionCohort Studieschemistry.chemical_compoundInternal medicineDiabetes mellitusmedicineAlbuminuriaHumansRenal InsufficiencyAgedCreatinineProteinuriabusiness.industryGeneral MedicineMiddle Agedmedicine.diseaseImpaired fasting glucoseEndocrinologyCross-Sectional StudiesGlucosechemistryDiabetes Mellitus Type 2NephrologyHyperglycemiaHypertensionFemalemedicine.symptombusinessGlomerular Filtration Ratedescription
The objective of this study was to assess the relationship between urinary albumin excretion (UAE) and GF across the spectrum of the glucose metabolism abnormalities in a large population of patients with hypertension. The Microaluminuria en Pacientes con Glucemia Basal Alterada (MAGAL) is a multicenter, cross-sectional study that was carried out by 1723 primary care physicians. A total of 6227 patients with essential hypertension (in three groups: [1] normal fasting glucose100 mg/dl, [2] impaired fasting glucoseor =100 to 126 mg/dl, and [3] type 2 diabetes) were analyzed in this substudy. GFR was estimated by using the Modification of Diet in Renal Disease (MDRD) abbreviated equation. A single first-morning urine albumin/creatinine ratio was measured using Bayer reagent strip Microalbustix, a semiquantitative method. Abnormal UAE was defined as an albumin/creatinine ratioor =3.4 mg/mmol (equivalent toor =30 mg/g). The prevalence of abnormal UAE,or =3.4 mg/mmol, increased across the spectrum of glucose abnormalities: 39.7, 46.2, 48.6, and 65.6% for normoglycemic, low-range, and high-range impaired fasting glucose and diabetes, respectively. UAE was positively related to SBP (P = 0.003) and inversely to GFR (P0.001). Renal insufficiency (GFR60 ml/min per 1.73 m2) was present in 21.8% of the patients, more frequently older patients, women, and those with diabetes. The factors that were related to renal insufficiency were UAEor =3.4 mg/mmol (odds ratio 1.86; 95% confidence interval 1.60 to 2.17) and diabetes (odds ratio 1.62; 95% confidence interval 1.29 to 2.04). There is a close relationship between abnormal UAE and renal insufficiency in essential hypertension. This is more marked in patients with diabetes and moderate in patients with high-range impaired fasting glucose.
year | journal | country | edition | language |
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2006-11-30 | Journal of the American Society of Nephrology : JASN |