Prevalence and risk factors of microalbuminuria in Thai nondiabetic hypertensive patients

Pongsathorn Gojaseni1, Angkana Phaopha1, Worawon Chailimpamontree1, Thaweepong Pajareya1, Anutra Chittinandana21Division of Nephrology, Department of Medicine, Bhumibol Adulyadej Hospital, Directorate of Medical Services, Royal Thai Air Force, Bangkok, Thailand; 2Department of Education, Directorate of Medical Services, Royal Thai Air Force, Bangkok, ThailandPurpose: To assess the prevalence and risk factors of microalbuminuria in nondiabetic hypertensive patients in Thailand.Patients and methods: A cross-sectional study was performed during January to December 2007 at outpatients departments of Bhumibol Adulyadej hospital. Nondiabetic hypertensive patients without a history of pre-existing kidney diseases participated in this study. A questionnaire was used for collecting information on demographics, lifestyle, and family history of cardiovascular and kidney disease. Spot morning urine samples were collected for albuminuria estimation. Albuminuria thresholds were evaluated and defined using albumin-creatinine ratio (ACR).Results: A total of 559 hypertensive patients (283 males, 276 females), aged 58.0 ± 11.6 years were enrolled in this study. Microalbuminuria (ACR 17 to 299 mg/g in males and 25 to 299 mg/g in females) was found in 93 cases (16.6%) [15.0%‑18.2%]. The independent determinants of elevated urinary albumin excretion in a multiple logistic regression model were; body mass index ≥30 (odds ratio (OR) = 2.24, 95% confidence intervals (CI): 1.33–3.76) and dihydropyridine calcium channel blockers (DCCB) use (OR = 1.92, 95% CI: 1.22‑3.02).Conclusion: In Thai nondiabetic hypertensive patients, microalbuminuria was not uncommon. Obesity and use of dihydropyridine calcium channel blocker were found to be the important predictors. Prognostic value of the occurrence of microalbuminuria in this population remains to be determined in prospective cohort studies.Keywords: microalbuminuria, hypertension, obesity, calcium channel blocker, metabolic syndrome