By Dr. BPS Tyagi Microalbuminuria or presence of albumin in the urine in micro amounts indicates early kidney damage; an early vascular endothelial dysfunction and early atherosclerosis with major cardio or cerebrovascular events and death.
Current guidelines advocate annual screening in patients with diabetes and wherever possible in non-diabetic patients with hypertension, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President-Elect IMA.
Early detection of high-risk patients allows selection of aggressive treatment to slow disease progression.
Antihypertensive agents providing angiotensin II blockade are recommended for the treatment of hypertensive patients with microalbuminuria, regardless of diabetes and/or early or overt nephropathy. Treatment with these drugs provides effective reduction of microalbuminuria and blood pressure, and long-term prevention of CV events beyond blood pressure reduction.
Even very low levels of microalbuminuria strongly correlate with cardiovascular risk. Albumin excretion rates as low as 4.8 µg/min, well below the microalbuminuria thresholds stated in current clinical guidelines, are associated with increased risk of cardiovascular and cerebrovascular disease, independent of the presence of other risk factors.