Urinary Albumin Excretion Rate: Diagnostic and Prognostic Utility in Essential Hypertension.

ABSTRACT

Context To evaluate the usefulness of urinary albumin excretion rate (UAER) i.e. Albumin/Creatinine Ratio (ACR) in diagnosis and prognosis of essential hypertension (EHT). Objectives: To find out the association of urinary albumin excretion rate with the pathophysiology of essential hypertension. Study Design: A cross-sectional analytical study. Materials & Methods: Urinary albumin excretion (UAE), urinary creatinine (UC) and UAER were analyzed and compared between hypertensive cases and age & sex matched normotensive controls of age group 30-65 years using unpaired two-tailed Student ‘t’ test. All statistical analyses were done with PASW (SPSS) v.18.0. Results: Systolic BP (SBP) and diastolic BP (DBP) of cases were found to be significantly higher (p < 0.001) than controls. Urine MAlb level (p < 0.001) and ACR (p < 0.001) in cases were significantly higher compared to controls. Correlation studies showed that SBP and DBP was significantly positively correlated with urine MAlb (SBP r = 0.859, DBP r = 0.733; p < 0.001) and ACR (SBP r = 0.830, DBP r = 0.739; p < 0.001). Sex-wise comparison in cases revealed that males had statistically non-significant (p > 0.05) lower levels of urine MAlb as compared to females but had significantly higher (p < 0.001) levels of urine creatinine and lower (p < 0.001) ACR compared to females. Conclusion: Urinary MAlb levels and ACR are seen to be increased in hypertensive subjects compared to normotensive subjects. ACR was significantly higher in female hypertensives than males which can be credited to the physiologically observed lower urine creatinine levels compared to males. Both Microalbuminuria and ACR can serve as specific and well-established marker of cardiovascular and renal damage in EHT.