International Research Journal of Basic and Clinical Studies Vol.4 (1): pp. 010-013, March, 2016
DOI: http://dx.doi.org/10.14303/irjbcs.2016.045
Available online http://www.interesjournals.org/IRJBCS
Copyright © 2016 International Research Journals
Full Length Research Paper
Prevalence of microalbuminuria in newly diagnosed
hypertensives in a tertiary hospital setting, using a
semi-quantitative screening tool
*Maxwell M. Nwegbu
1
, Ganiyu A. Akintan
2
, Elijah O.Irabor
3
1
Department of Chemical Pathology, College of Health Sciences, University of Abuja, Abuja, Nigeria
2
Department of Medical Biochemistry, College of Health Sciences, University of Abuja, Abuja,
Nigeria.
3
College of Health Sciences, University of Abuja, Abuja, Nigeria
*Corresponding Author’s Email: maxwellnwegbu@gmail.com
Abstract
Microalbuminuria, a subtle increase in the urinary excretion of albumin that cannot be detected by the
conventional urinalysis method, is an early marker of cardiovascular complications and increased
cardiovascular risk in hypertension. The prevalence of microalbuminuria (MAU) is prone to modification by
factors such as age, race, and severity of the disease process and presence of co-morbid factors. In view
of this, a range of rates abound from various studies. In addition the methodologies of evaluation of MAU
also contribute to the observed differences in prevalence reported in literature. Due to the challenges of
24-hour urine estimation, albumin excretion rate (AER) methods using spot urine has gained wide clinical
acceptance. In our environment however, AER methods are not in widespread routine use and patients are
still assessed by conventional dipsticks for urinalysis with the consequence outcome of not identifying
patients with MAU. In this study, we evaluated sixty-four newly diagnosed hypertensives for MAU using a
semi-quantitative urine test strip based on the immunoassay principle (ChemstripMicral
TM
-Roche). The
prevalence of MAU was 47% in our study and these subjects had all been evaluated with the conventional
urine dipsticks. Of our study subjects, only a third was on reno-protective medications such as
angiotensin-converting enzyme inhibitors. These findings indicate the need for the introduction of
screening for MAU using these types of strips in lieu of the current conventional urinalysis in the
assessment of hypertensives. This can be used for stratification of the patients to allow for subsequent
AER evaluation in those detected as having MAU by this screening tool. This is important as it will guide
treatment choices for the patients, especially given the challenges of cost in our resource-poor
environment.
Keywords: Hypertension, Albuminuria, Albumin excretion rate, Dipstick, Cardiovascular disease
INTRODUCTION
Proteinuria, majorly in the form of albuminuria has been
associated with adverse clinical outcomes. Overt
albuminuria, macroalbuminuria, or proteinuria is defined
as a urinary albumin excretion of ≥ 300 mg/24 h and this
usually, can be detected by routine urinalysis using the
conventional dipsticks. Microalbuminuria (MAU), defined
as persistent elevation in levels of albumin ranging from
>30 to <300 mg in a 24-h urine collection cannot be
detected by the usual urinalysis strips as these levels fall
below the detection limit of these strips. MAU is a marker
of endothelial dysfunction and widely accepted as a
predictor of renal decline in patients with hypertension,
risk of cardiovascular mortality, cerebrovascular disease
and peripheral artery disease. (Chugh and Bakris, 2007;
Weir, 2007). Studies have also shown that the presence
of microalbuminuria predicts all-cause mortality in the
general population in addition to those with concomitant
hypertension where the relative risk is much higher.