Microalbuminuria in subclinical target organ damage and its correlation to creatinine clearance ratio in hypertension

Abstract

Background: Urinary albumin excretion has been purported to be strongly linked to cardiovascular events in hypertensive patients. The prevalence of microalbuminuria in patients with essential hypertension and its relationship with target organ damage was evaluated with the present study, as the correlation of microalbuminuria and target organ damage except cardiovascular events has not been deliberated upon much in the past. Objectives: To evaluate the relationship between microalbuminuria and reduced creatinine clearance with subclinical target organ damage in asymptomatic nondiabetic hypertensive patients. Methodology: 120 hypertensive cases were studied from January 2019 to December 2020 in Dr VRK Womens Medical College, Hyderabad. Cases were evaluated for microalbuminuria, creatinine clearance, left ventricular hypertrophy and hypertensive retinopathy. Creatinine clearance was estimated by the Cockcroft-Gault formula. Left ventricular hypertrophy was determined by ECG and echocardiography. Retinal vascular changes were evaluated by direct ophthalmoscopy. Microalbuminuria was detected in 24 hours urine sample by immunoturbidimetric, assay. Results: There was significant association between microalbuminuria (30%) and reduced creatinine clearance (38%) with target organ damage i.e. left ventricular hypertrophy [p < 0.002 & p 0.002 respectively] and hypertensive retinopathy [p 0.005 & p 0.03 respectively]. Patients with urine microalbumin had 30 times risk [95% CI: 3.6-253, p 0.001] and those with reduced creatinine clearance had 5.9 times the risk [95% CI: 1.7-19.4, p 0.0035] of developing target organ damage. But when present together the risk increased to 39.4 times [95% CI: 2.2-703, p 0.0124]. Conclusion: Results show that a reduction in creatinine clearance and/or presence of microalbuminuria is a marker of subclinical organ damage in patients with primary hypertension. Microalbuminuria showed better association with target organ damage than reduced creatinine clearance.