Microalbuminuria: It's Significance, risk factors and methods of detection

Authors

  • Lucy E Yaguo-Ide Department of Pediatrics and Child Health, University of Port-Harcourt, Port-Harcourt, Rivers state
  • Nwadiuto A Akani Department of Pediatrics and Child Health, University of Port-Harcourt, Port-Harcourt, Rivers state

DOI:

https://doi.org/10.60787/tnhj.v11i1.40

Keywords:

Microalbuminuria, Screening, Risk factors, Methods of detection.

Abstract

Background: Microalbuminuria, though a relevant screening tool worldwide, is scarcely reported with very sparse literature in our setting. Microalbuminuria is a marker of early renal involvement, compare to routine serum creatinine and electrolytes changes in hypertension and diabetes mellitus. This article attempts to review the significance, risk factors and methods of detection of Microalbuminuria.

Methods: Available publications from local and international journals in addition to Medline and Google search, particularly for local references were utilized. Other sources of our data included dissertations from the library of National post graduate medical college and text books of pediatric nephrology.

Results: Microalbuminuria is used extensively in diabetes mellitus as a sensitive test for the detection of preclinical kidney dysfunction prior to the development of overt proteinuria, and as a predictor of subsequent diabetic nephropathy. It has been found to be an important prognostic indicator in meningitis, malignancy and hypertension. It has been found to be useful in the monitoring of patients with renal scarring, unilateral nephrectomy and diabetes mellitus. It is also an important marker of glomerular injury, particularly in patients with sickle cell anaemia.

Conclusion: Microalbuminuria is an early maker of glomerular injury. It is important as a screening tool in a variety of disease conditions. Screening may be performed with a semi quantitative assay. If the screen is positive, UAE should be evaluated by a quantitative assay.

Downloads

Download data is not yet available.

References

Verroti A, Catino M, Di-Riccol et al. Prevalence ofmicrovascular complications in diabetic children and adolescents. Acta Paediatr. 1999; 88: S35-38

Solardi S, Carriari E, Pascucci MG et al. Microalbuminuria in diabetic children and adolescents; relationship with puberty and growth hormone. Acta Paediatr Scand 1990; 79: 437-439

Janssen WM, De-Jong PE, De-Zeeuwd. Hypertension and renal disease: role of Microalbuminuria. J Hypertens suppl 14: 173-177

Albert M, Ribstein J, Guihem Du Cailer. Microalbuminuria in essential hypertension, current opinion in nephrology and hypertension. 1999; 8: 359-363.

Kilaru P. Bakris Gl. Microalbuminuria and progressive renal disease. J Hum Hypertens 1994; 8: 809-811.

Marshall SM. Screening for Microalbuminuria: which measurement ? Diabetic Med 1991; 8: 706-711.

Mimran A, Ribstein J, Ducarlar G. Microalbuminuria in essential hypertension: Current opinion in nephrology and hypertension 1999; 8: 359-363.

Winocour PH. Microalbuminuria: Worth screening for in early morning urine samples in diabetic, hypertensives and elderly patients. BMJ 1992; 304: 1196-1197.

Hasskcher CH, Ritz E, Wahl P, Michael C. Similar risk of nephropathy in patients with type I or type II diabetes mellitus. Neprol Dial Transplant 1989; 4: 859-863

Croz CC, Spitzer A. When you find protein or blood in the urine. Contemporary Paediatr 1998; 15: 89-109.

Ginsberg JM, Chang BS, Matarese RA et al. Use ofsingle voided urine samples to estimate quantitative proteinuria. N Engl J Med 1983; 309: 1543.

Yusuf S, Sleight P, Pogue J et al. The heart outcomes prevention evaluation study investigators. Effect of an angiotensin converting enzyme inhibitor ramipril, on cardiovascular events in high risk patients. N Engl J Med 2000; 342: 145-153.

Miettinen H, Haffner SM, Lehto S et al. Proteinuria predicts stroke and other atherosclerotic vascular disease events in non diabetic and non insulin dependent diabetic subjects. Stroke 1996; 27: 2033-2039.

Borch-Johnson K, Feldt-Rasmussen B, Strandgaard S et al. Urinary albumin excretion. An independent predictor of ischaemic heart disease. Atheroscle Thromb Vasc Biol. 1999; 19: 1992-1997.

Yudkin JS, Forest RD, Jackson CA. Microalbuminuria as predictor of vascular disease in non diabetic subjects. Lancet 1988; 2: 530-533.

Roine I. Microalbuminuria: an index of severity in childhood meningitis. The paediatr Infect Dis 1993; 12 : 584-588.

Sawyer N, Wadsworth J, Wijnen M et al. Prevalence, concentration and prognostic importance of proteinuria in patients with malignancies. B Med J 296; 1295-1298.

Viberti G. Prognostic significance of Microalbuminuria. Am J Hypertens 1994; 7: 695-725.

Karlen J, Linne T, Wilkstad I, et al. Incidence ofMicroalbuminuria in children with pyelonephritis scarring. Pediatr Nephrol 1996; 10: 705-708.

Srinivas M, Agarwala S, Padhy AK, et al. Somatic growth and renal function after unilateral nephrectomy for wilms tumour. Paediatr-surg-intern 1988: 185-188.

Chevalier C, Hadj-Aissa A, Brunat- Mentigny M, et al. Renal function after nephrectomy for wilms tumour. Arch- Paediatr 1997; 7: 639-644

Viberti G, Hill RD, Jarrett RJ, et al. Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet 1982; 1:1430-1432.

Mogensen CE, Christensen CK. Predicting diabetic nephropathy in insulin- dependent patients. N Eng J Med 1984; 311: 89-93.

Sergent GR. Sickle cell disease : oxford University press, London. 1985:1-222.

Falk RJ, Jenette JC: Renal disease In: Embury SH, Hebbel RP, Mohandas N, Steinberg MH eds. Sickle cell disease. Basic principles and clinical practice. New York, Raven Press limited, (publishers) 1994: 673-679.

Scheinman JI. Sickle cell nephropathy. In: Barrat TM, thAvner ED, Harman WE eds. Paediatric nephrology, 4ed. Baltimore, Lippincott Williams and Wilkins 1999: 497-506.

Vichinsky EP, Lubin BH. Sickle cell anaemia and related haemoglobinopathies. Paed Clin North Am 1980; 27: 436

Van Eps LWS, De Jong PE. Sickle cell disease. In : Schrier RW ed. Diseases of the kidney and urinary tract, th7 ed. Philadelphia, Lippincott Williams and Wilkins 2001; 111:2281-2299.

Ataga KI, Orringer EP. Renal abnormalities in sickle cell disease. Am J Hematol 2000; 63: 205-211.

Allon M. Renal abnormalities in sickle cell disease. Arch Intern. Med 1990; 150: 501-504.

Van Eps LW, Leeksma OC. Sickle cell nephropathy . In : Remuzzi G Rossi CE eds. Haematosis and the kidney. Lexisnexis, Butterworths and co limited ( publishers) 1989: 169-190.

Platt SO, Dover GJ. Sickle cell disease In : Nathan DG, Oski FA eds. Haematology of Infancy and Childhood. Philadelphia, WB Saunders CO ( publishers ) 1993: 732-782

Barrat-Conner E. Bacterial infection and sickle cell anaemia, an analysis of 250 infections in 166 patients and a review of the literature. Medicine 1971; 50: 97-112.

Pardo V, Strauss J, Kramer H, Ozawa T, McIntosh RM. Nephropathy associated with sickle cell anaemia : an autologous immune complex nephritis 11. Clinicopathologic study of seven patients. Am J Med 1975; 59: 650-659.

Strauss J, Pardo V, Koss MN et al. Nephropathy associated with Sickle cell anaemia . An autologous immune complex nephritis 1. Studies on nature ofglomerular-bound antibody and antigen identification in a patient with Sickle cell disease and immune deposit glomerulonephritis. Am J Med 1975; 58: 382-387.

Fox SI. Physiology of the kidneys. In : Human Physiology. Boston, WBC, McGraw-Hill, 1999: p.528.

Van Eps LWS, De Jong PE. Sickle cell disease. In : Schrier RW, Gott Schalk CW eds. Disease of the kidney. Boston, Little Brown and Co (publishers) 1997: 561-590.

Brezis M, Rosen S. Hypoxia of the renal medulla, its implication for disease. N Engl J Med 1995; 332: 647- 653.

Rubin MI, Baliah T. Urinalysis and its clinical interpretation. Paed clin North Am 1971; 18: 245-264.

Ugwu RO, Eke FU, Urinary abnormalities in children with sickle cell anaemia. Port Harcourt Medical Journal 2007; 2: 43-50

Adedoyin OT, Akindele JA, Ajayi OA et al Urinalysis in Clinically Stable Nigerian children. Nig J Paediatr 2002; 27: 1-5

Oviasu E, Oviasu SVA. Urinary abnormalities in asymptomatic adolescent Nigerians. W Afr J Med 1994; 13: 152-155

Ekunwe EO. Odunjirin OMT. Proteinuria and blood pressure profile in Lagos school children. Nig J Paediatr 1989; 16: 15-22

bdurrahman MB, Chakrabarty DP, Ochoga SA. Bacteriuria and other urinary abnormalities among primary school children in Kaduna. Nig J Paediatr. 1978; 5(2): 21-24

Akinkugbe FM, Familusi JB, Akinkugbe OO.Urinary tract infection in infancy and early childhood. East Afri Med J 1973; 50: 514-520

Akinkugbe FM, Akinwolere OAO, Oyewole AIM. Isolated proteinuria in asymptomatic Nigerian children. Nig J Paediatr 1991; 18:32-36

Ikimalo FE. Urinary Screening for detection ofAsymptomatic Haematuria and Proteinuria in children in an Urban and Periurban School, Port Harcourt , Rivers State. FMCPaed Thesis National Postgraduate Medical College of Nigeria, 1999.

Onifade EU. A Study of Proteinuria Among Rural, Primary School Children FMCPaed Thesis National Postgraduate Medical College of Nigeria, 1992.

Ibadin MO, Onunu A, Unuigbe E, et al.Microalbuminuria in adolescent/young adult offspring of hypertensive Nigerian adults. Nig J Clin Pract 2004; 7: 60-64.

Aoki RY, Saad ST. Microalbuminuria in sickle cell disease. Braz. J Med Boil. Res. 1990; 23: 1103-1106

Datta V, Ayenger JK, Karpates S, Chaturvedi P. Microalbuminuria as a predictor of early glomerular injury in children with sickle cell disease. Indian J Paed. 2003; 70: 307-309.

McBurney PG, Hanevold CP, Hermandes CM, Walter JL, Mckie KM. Risk factors for Microalbuminuria in children with Sickle cell anaemia. J Paediatr Hematol Oncol. 2002; 24: 473-477.

Dharnidharka VR, Dabbagh S, Atiyeh B et al. Prevalence of Microalbuminuria in children with sickle cell disease. Paediatr Nephrol 1998; 12: 475-478

Dirckx JH, Stedmans concise medical dictionary for thhealth professionals. 4 edition Baltmore. Lippincott Williams and Wilkins. 2001: 662.

Sesso K, Almeida MA, Figueirido MS et al, Renal dysfunction in patients with sickle cell anaemia or sickle cell trait. Braz J Med Biol Res 1998; 31: 1257-1262.

Yaguo Ide LE. Prevalence of Microalbuminuria in Paediatric Patients with sickle cell anaemia attending the Anaemia Clinic of University of Port Harcourt Teaching Hospital. FMCPaed National Postgraduate Medical College of Nigeria. November, 2008.

Abhulimhen-Iyoha B.J Microalbuminuria in children with sickle cell anaemia in Benin city. FMCPaed National Postgraduate Medical College of Nigeria. April 2007.

Eke C.B Microalbuminuria in children with Sickle cell anaemia seen at University of Nigeria Enugu Teaching Hospital FWACP April 2010.

De Jong PE, Brenner MB. From secondary to primary prevention of progressive renal disease: The case for screening for albuminuria. Kidney Int 2004 ; 66: 2109- 2118.

Brenner BM, Meyer TW, Hostetter TH. Dietary protein intake and progressive nature of kidney disease :The role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerulosclerosis in aging, renal ablation and intrinsic renal disease N Engl J Med 1982; 307 : 652-659

Abbate M, Zoja C, Corna D et al. In: Progressive nephropathies overload of tubular cells with filtered proteins translates glomerular permeability dysfunction into cellular signals of interstitial inflammation. J Am Soc nephrol 1993; 9: 1213-1224.

Oldrizzi L, Rugiu C, De Biase V, Maschio G. The place of hypertension among risk factors for renal function in Chronic renal failure. Am J Kidney Dis 1993; 21: 119-123.

Williams PS, Fass G, Bone JM. Renal pathology and proteinuria determine progression in untreated mild / moderate Chronic renal failure. QJM 1988; 67: 343-354.

Maschio G, Oldrizzi L, Rugiu C et al. Factors affecting progression of renal failure in patients on long term dietry protein restriction. Kidney Int 1987; 32: 49-52.

Perneger TV, Whelton PK, Klag MJ. Race and end stage renal disease, socioeconomic status and access to healthcare as mediating factors. Arch Int Med 1995; 155: 1201-1208.

Bonnet F, Deprele C, Sassolas A et al. Excessive body weight as a new independent risk factor for clinical and pathological progression in primary IgA nephritis. Am J Kidney Dis 2001; 37: 720-727.

Orth SR, Ritz E, Schrier RW. The renal risk of smoking. Kidney Int 1997; 51: 1669-1677.

Brenner BM, Chertow GM. Congenital Oligonephropathy and the etiology of adult hypertension and progressive renal injury. Am J Kidney Dis. 1994; 23: 171-175.

Silbiger SR, Neugarten J. The impact of gender on the progression of chronic renal disease. Am J Kidney Dis. 1995; 25: 515-533.

Metcalf PA, Barker JR, Scragg RK et al .Microalbuminuria in a middle aged work force, effect ofhyperglycaemia and ethnicity. Diabetes care 1999; 16: 1485-1493.

Hoy WE, Rees M, Kile E et al. A new dimension to the Barker hypothesis. Low birth weight and the susceptibility to renal disease. Kidney Int 1999; 56: 1072-1077.

Lackland DT, Bendall HE, Osmond C, Egan BM, Bark DJ. Low birth weight contribute to high rates of early on set chronic renal failure in the south eastern united states. Arch Intern Med 2000; 160: 1472-1476.

Brenner BM, Chertow GM. Congenital Oligonephropathy. An inborn course of adult hypertension and progressive renal injury? Curr Opin Nephrol Hypertens 1993; 2: 691-695.

Gould MM, Mohamed-Ali V, Goubet SA et al. Microalbuminuria association with height and sex in non diabetic subjects. BMJ 1993; 306: 240-242.

Hillege HL, Janssen WM, Bak AA et al. Microalbuminuria is common, also in non diabetic, non hypertensive population, and an independent indicator of cardiovascular risk factors and cardiovascular morbidity. J Intern Med 2001; 249: 519-526.

DamsGaard EM, Froland A, Jorgensen OD, Mogensen CE. Microalbuminuria as predictor of increased mortality in elderly people BMJ 1990; 300: 297-300.

Verhave JC, Hillege HL, Burgerhof JGM et al. Cardiovascular risk factors are differently associated with urinary albumin excretion in men and women. J Am Soc Nephrol 2003; 14: 1330-1335.

Lindeman RD, Shock TJ. Longitudinal studies on the rate of decline in renal function with age. J Am Geriatr Soc 1985; 33: 278-285.

Yudkin IS, Phillips DL, Stanner S. Proteinuria and progressive renal disease: Birth weight and Microalbuminuria. Nephrol Dial Transplant 1997; 12: 10-13.

Parring HH, Oxemball B, Svendsen PA et al. Early detection of patients at risk of developing diabetic nephropathy. Acta Endocrinol 1982; 100: 550-555.

Rudberg S, Person B, Dahlquist G. Increased glomerular filtration rate as a predictor of diabetic nephropathy. An 8year prospective study. Kidney Int 1992; 41: 822-828.

Mogensen CE, Microalbuminuria predicts clinical proteinuria and early mortality in maturity onset diabetes. N Engl Med 1986; 310 : 356 360

Stehouwer CDA, Fischer HRA, Van kuude AWR, et al. Endothelial dysfunction precedes development ofMicroalbuminuria in insulin dependent diabetes mellitus. Diabetes 1995; 44: 561-564.

Stehouwer CDA, Nauta JJP, Zeldenrust GC et al. Albuminuria, Cardiovascular disease and endothelial dysfunction in non insulin dependent diabetes mellitus. Lancet 1992; 340:319-323

Parving HH, Mogensen CE, Jensen HA, Evrin PE. Increased urinary albumin excretion rate in benign essential hypertension. Lancet 1974; 1: 1190-1192

Metcalf P, Baker J, Scott A, et al. Albuminuria in people at least 40 years old: Effect of obesity, hypertension, and hyperlipidaemia. Clin chem. 1992; 38:1802-1808.

Pedrinelli R, Glampietro O, Carmassi F, et al. Microalbuminuria and endothelial dysfunction in essential hypertension. Lancet 1994; 344: 14-18

Cerasola G, Corrone S, Mule G, et al. Microalbuminuria, renal dysfunction and cardiovascular complication in essential hypertension. Hypertens 1996; 14:915-920

Valensi P, Assayayag M, Busby M, et al. Microalbuminuria in obese patients with or without hypertension. In J obesity 1996; 20:574-579

Pinto-Sietsma SJ, Navis G, Janssen WMT, et al. A central fat distribution is related to renal function abnormalities, even in lean subjects. Am J kidney Dis 2003;41:733-741

Ribstein J, Du cailar G, Mimran A. Combined Renal effects of overweight and Hypertension. Hypertension 1995; 26:610-615

Pinto-sietsma SJ, Mulder J, Janssen WM, et al. smoking is related to albuminuria and abnormal renal function in non-diabetic persons. Ann Intern Med 1998;158:1933-1939

Briganti EM, Branley P, Chadban SJ et al. Smoking is associated with renal impairment and proteinuria in normal population.

Mantarri M, Tiula E, Alikoski T, ManninenV. Effects ofhypertension and dyslipidemia on the decline in renal function. Hypertension 1995; 26: 670-675

Du cailar G, Ribstein J, Mimran A. Dietary sodium and target organ damage in essential hypertension. Am J Hypert 2002; 15: 222-229

Tuomilehto J, Jousllahti P, Rasieyfe D, et al. Urinary sodium excretion and cardiovascular mortality in Finland. A prospective study. Lancet 2001; 357: 848-851

Monster TB, Janssen WM. De Jong PE, Jong-Van Den Berg LTW. Oral contraceptives and hormone replacement therapy are associated with Microalbuminuria. Arch Intern Med 2001; 161:2000-2005

Ribstein J, Halimi JM. Du CG, Mimran A. Renal characteristics and effect of angiotensin suppression in oral contraceptives users. Hypertension 1999;33:90-95

Kang AK, Duncan JA, cattran DC et al. Effect of oral contraceptives on the renin angiotensin system and renal function. Am J Physiol Regul Integr Comb Physiol 2001;280:807-813

Rowe DJF, Dawney A, Watts GF: Microalbuminuria in diabetes mellitus: review and recommendation for the measurement of albumin in urine Ann clin Biochem 1990;27:297-312

Ganong WF. Renal function and micturition. In: Butler JP, Suver AM, Langman C eds. Review of medical thphysiology, 18 edition, Stamford, Appleton and Lange (publishers) 1997: 653-681.

Rowe DJ, Bagga H, Betts PB. Normal variations in rate of albumin excretion and albumin to creatinine ratios in overnight and day time urine collections in non diabetic children. BMJ 1985; 291: 693-694.

Downloads

Published

2015-12-02

How to Cite

Yaguo-Ide, L. E., & Akani, N. A. (2015). Microalbuminuria: It’s Significance, risk factors and methods of detection. The Nigerian Health Journal, 11(1), 1. https://doi.org/10.60787/tnhj.v11i1.40
Abtract Views | PDF Download | EPUB Download: 852 / 112

Similar Articles

<< < 1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.