Distribution Pattern of Urine Albumin Creatinine Ratio and the Prevalence of High-Normal Levels in Untreated Asymptomatic Non-Diabetic Hypertensive Patients
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- Ohmaru Natsuki
- Department of Medical Technology, Okayama University Graduate School of Health Sciences, Japan
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- Nakatsu Takaaki
- Department of Cardiology, Kagawa-ken Saiseikai Hospital, Japan
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- Izumi Reishi
- Department of Medical Technology, Okayama University Graduate School of Health Sciences, Japan
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- Mashima Keiichi
- Department of Cardiology, Kagawa-ken Saiseikai Hospital, Japan
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- Toki Misako
- Department of Cardiology, Kagawa-ken Saiseikai Hospital, Japan
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- Kobayashi Asako
- Department of Cardiology, Kagawa-ken Saiseikai Hospital, Japan
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- Ogawa Hiroko
- Department of Cardiology, Kagawa-ken Saiseikai Hospital, Japan
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- Hirohata Satoshi
- Department of Medical Technology, Okayama University Graduate School of Health Sciences, Japan
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- Ikeda Satoru
- Department of Medical Technology, Okayama University Graduate School of Health Sciences, Japan
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- Kusachi Shozo
- Department of Medical Technology, Okayama University Graduate School of Health Sciences, Japan
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Background Even high-normal albuminuria is reportedly associated with cardiovascular events.<br> Objective We determined the urine albumin creatinine ratio (UACR) in spot urine samples and analyzed the UACR distribution and the prevalence of high-normal levels.<br> Patients and Methods The UACR was determined using immunoturbidimetry in 332 untreated asymptomatic non-diabetic Japanese patients with hypertension and in 69 control subjects. The microalbuminuria and macroalbuminuria levels were defined as a UCAR ≥30 and <300 μg/mg·creatinine and a UCAR ≥300 μg/mg·creatinine, respectively.<br> Results The distribution patterns showed a highly skewed distribution for the lower levels, and a common logarithmic transformation produced a close fit to a Gaussian distribution with median, 25th and 75th percentile values of 22.6, 13.5 and 48.2 μg/mg·creatinine, respectively. When a high-normal UACR was set at >20 to <30 μg/mg·creatinine, 19.9% (66/332) of the hypertensive patients exhibited a high-normal UACR. Microalbuminuria and macroalbuminuria were observed in 36.1% (120/336) and 2.1% (7/332) of the patients, respectively. UACR was significantly correlated with the systolic and diastolic blood pressures and the pulse pressure. A stepwise multivariate analysis revealed that these pressures as well as age were independent factors that increased UACR.<br> Conclusion The UACR distribution exhibited a highly skewed pattern, with approximately 60% of untreated, non-diabetic hypertensive patients exhibiting a high-normal or larger UACR. Both hypertension and age are independent risk factors that increase the UACR. The present study indicated that a considerable percentage of patients require anti-hypertensive drugs with antiproteinuric effects at the start of treatment.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 50 (16), 1621-1629, 2011
一般社団法人 日本内科学会
