Prevalence of Microalbuminuria and It's correlation with duration and severity of Hypertension

Sathishkumar, S (2010) Prevalence of Microalbuminuria and It's correlation with duration and severity of Hypertension. Masters thesis, Madurai Medical College, Madurai.

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Abstract

INTRODUCTION: Microalbuminuria has been defined as albumin excretion of 20 to 200 mcg / minute or 30 to 300 mg /24 hour in a 24 hour urinary sample. Anything above this level is called macroalbuminuria. Microalbuminuria can also be defined in terms of the urinary albumin –to – creatinine ratio (UACR). A ratio greater than 30 mg /g in the first voided sample in the morning (clean, midstream) is considered abnormal. AIMS AND OBJECTIVES: 1. To study the prevalence of microalbuminuria in patients with hypertension. 2. To study whether microalbuminuria correlates with duration of hypertension. 3. To study whether microalbuminuria correlates with severity of hypertension-JNC 7 staging. 4. To study whether microalbuminuria correlates with severity of Target organ damage (TOD). MATERIALS AND METHODS: Setting: Outpatient clinic of Government Rajaji Hospital, Madurai. Design of Study: Analytical-cross sectional study. Period of Study: Six months (August 2008-January 2009). Sample Size and Selection of Study Subjects: Sixty hypertensive patients (both newly and previously diagnosed) attending the outpatient clinic were included in this Analytical-cross sectional study. This study group included 33 males and 27 females. The subjects included in the age groups ranging between 20yrs and 70yrs. Details of Study Subjects: Blood pressure was recorded using sphygmomanometer with standard cuff on 2 occasions 10 minutes apart. Patients should have refrained from smoking or drinking tea or coffee for at least 30 minutes before measuring BP .The higher of the two readings was taken as the patient’s blood pressure. Patients’ height and weight were measured and the body mass index was calculated using the formula weight/height. All the peripheral pulses were checked with special attention to carotids and femorals, to detect evidence for early atherosclerosis. An ocular fundus examination was done to detect hypertensive retinopathy. All the subjects had routine urine analysis (albumin, sugar and deposits) done. Fasting and 2 hour postprandial blood sugar, serum urea and creatinine were estimated. A 12 lead electrocardiogram and chest X-ray were also taken. All the patients were instructed to report with first early morning urine sample. Albumin in the urine is very stable at normal temperature, so urinary samples need not be frozen when sent to laboratory. Microalbuminuria was detected by the immunoturbidometric assay. CONCLUSION: In this study of 60 patients with hypertension, the prevalence of microalbuminuria was found to be high. The presence of microalbuminuria in hypertension is statistically correlated with the duration of hypertension. This study showed statistically significant correlation with systolic blood pressure and pulse pressure, but not with diastolic pressure. This study showed statistically significant correlation with severity of hypertension (JNC 7 STAGING). This study showed statistically significant correlation with target organ damage. Therefore urinary screening for microalbuminuria in patients with hypertension improves the targeting of primary prevention and should result in the reduction of target organ damage.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Prevalence ; Microalbuminuria ; severity of Hypertension.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 16 Mar 2018 02:38
Last Modified: 16 Mar 2018 02:38
URI: http://repository-tnmgrmu.ac.in/id/eprint/6287

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