The importance of microalbuminuria as a cardiovascular risk indicator: A review

The present review describes the knowledge of microalbuminuria as a cardiovascular risk indicator. Microalbuminuria is usually defined as a urinary albumin excretion rate of 30 to 300 mg in a 24 h urine collection, or as a urinary albumin excretion rate of 20 to 200 mg/min in a timed overnight urine...

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Bibliographic Details
Published inCanadian journal of cardiology Vol. 18; no. 5; p. 525
Main Authors Diercks, G F H, van Boven, A J, Hillege, J L, de Jong, P E, Rouleau, J L, van Gilst, W H
Format Journal Article
LanguageEnglish
Published England 01.05.2002
Subjects
Albuminuria - diagnosis
Albuminuria - epidemiology
Albuminuria - urine
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - urine
Comorbidity
Diabetes Mellitus - epidemiology
Diabetes Mellitus - urine
Endothelium, Vascular - physiopathology
Humans
Hypertension - epidemiology
Hypertension - urine
Predictive Value of Tests
Prevalence
Risk Factors
Urinalysis - methods
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Summary:The present review describes the knowledge of microalbuminuria as a cardiovascular risk indicator. Microalbuminuria is usually defined as a urinary albumin excretion rate of 30 to 300 mg in a 24 h urine collection, or as a urinary albumin excretion rate of 20 to 200 mg/min in a timed overnight urine collection, although microalbuminuria was demonstrated to be a predictor for cardiovascular events at levels below these conventional cut-off values. More than one consecutive urine collection is preferred given the high day to day variability of urinary albumin excretion. Microalbuminuria is frequently present and a known cardiovascular risk indicator in diabetic populations. Also, in hypertensive and general populations, microalbuminuria is common and has been associated with an adverse atherogenic risk profile and a higher prevalence of cardiovascular disease. Moreover, evidence strongly suggests that microalbuminuria is also an independent predictor of cardiovascular disease in these populations. However, more prospective studies are needed to elucidate fully the value of microalbuminuria as a cardiovascular risk indicator in hypertensive and general populations. Generalized endothelial dysfunction has been hypothesized to be the underlying factor for microalbuminuria on one hand and the underlying factor for increased cardiovascular risk on the other. In this respect, the loss of the glycosaminoglycan heparin sulphate might be an important pathophysiological mechanism. This hypothesis needs further clarification, especially in nondiabetic populations.
ISSN:0828-282X