Renal and cardiovascular risk predictive value of two different microalbuminuria screening methods in patients with hypertension with/without diabetes in Portugal

J Hum Hypertens. 2016 Nov;30(11):726-730. doi: 10.1038/jhh.2015.120. Epub 2016 Jan 7.

Abstract

MicRoAlbuminuria sCreening survEy (RACE) was a multicentre, observational, cross-sectional study conducted in primary health-care settings of Portugal. Here, we present a post-hoc analysis from the RACE study, assessing the renal and cardiovascular (CV) risk predictive value of two different microalbuminuria (MA) screening methods, nephelometry with 24-h urine (MA-24 h) and Micral test with occasional urine (MicralA) in patients with hypertension (HTN) with/without type 2 diabetes mellitus (T2DM). Out of 3065 patients, 1173 (38.3%) were in the HTN group without T2DM (HTN) and 1892 (61.7%) in the HTN group with T2DM (HTN+T2DM). The overall prevalence of MA was 50.6% determined by MicralA and 22.1% with MA-24 h. Urinary albumin excretion data obtained by both techniques correlated significantly (rs=0.586; P<0.001). In all subjects, MicralA showed a sensitivity of 93%, specificity of 62% for detection of MA, with a positive predictive value of 41% and negative predictive value of 97%. With both methods, the presence of MA was independently associated with a higher risk (1.5- to 2.9-fold) of CV and renal organ damage in both HTN and HTN+T2DM groups. MicralA, due to its high sensitivity and negative predictive value, can be considered as a valid and reliable method for MA screening in patients with HTN with/without T2DM.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Albuminuria / diagnosis*
  • Albuminuria / epidemiology*
  • Area Under Curve
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetic Nephropathies / diagnosis*
  • Diabetic Nephropathies / epidemiology*
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology*
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Nephelometry and Turbidimetry
  • Portugal / epidemiology
  • Predictive Value of Tests
  • Prevalence
  • Primary Health Care
  • ROC Curve
  • Reproducibility of Results
  • Risk Factors
  • Urinalysis