Gojaseni Pongsathorn, Phaopha Angkana, Chailimpamontree Worawon, Pajareya Thaweepong, Chittinandana Anutra
Division of Nephrology, Department of Medicine, Bhumibol Adulyadej Hospital, Directorate of Medical Services, Royal Thai Air Force, Bangkok, Thailand.
Vasc Health Risk Manag. 2010 Mar 24;6:157-65. doi: 10.2147/vhrm.s9739.
To assess the prevalence and risk factors of microalbuminuria in nondiabetic hypertensive patients in Thailand.
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).
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 > or =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).
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.
评估泰国非糖尿病高血压患者微量白蛋白尿的患病率及危险因素。
2007年1月至12月在诗丽吉王后医院门诊部进行了一项横断面研究。无既往肾脏疾病史的非糖尿病高血压患者参与了本研究。使用问卷收集人口统计学、生活方式以及心血管和肾脏疾病家族史等信息。收集清晨随机尿样以评估白蛋白尿。采用白蛋白-肌酐比值(ACR)评估并定义白蛋白尿阈值。
本研究共纳入559例高血压患者(男性283例,女性276例),年龄58.0±11.6岁。93例(16.6%)[15.0%-18.2%]患者存在微量白蛋白尿(男性ACR为17至299mg/g,女性为25至299mg/g)。多因素logistic回归模型中尿白蛋白排泄升高的独立决定因素为:体重指数≥30(比值比(OR)=2.24,95%置信区间(CI):1.33 - 3.76)以及使用二氢吡啶类钙通道阻滞剂(DCCB)(OR = 1.92,95%CI:1.22 - 3.02)。
在泰国非糖尿病高血压患者中,微量白蛋白尿并不少见。肥胖和使用二氢吡啶类钙通道阻滞剂是重要的预测因素。该人群中微量白蛋白尿发生的预后价值仍有待在前瞻性队列研究中确定。