Albuminuria as a marker of kidney injury and cardiovascular risk


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Abstract

Growing albuminuria was considered to be a marker of early stages of hypertonic and diabetic nephropathy for a long time. Now days it has the meaning of the integral marker of unfavorable prognosis. Its forecasting role is very important due to the fact that it reflects the generalized endothelial dysfunction, determining the injury of target organs (myocardium, vascular wall, kidney). This damage is well observed even for insignificant increase of albumin excretion. A lot of therapeutic strategies, applied to decrease cardiovascular risk and kidney injury, can reduce albuminuria, but the most effective one includes the use of angiotensin-converting enzyme inhibitors and angiotensin II receptors blockers

References

  1. Мухин Н.А., Моисеев В.С. Кардиоренальные соотношения и риск сердечно-сосудистых заболеваний. Вестник РАМН 2003; 11: 50 - 55.
  2. De Jong P.E., Brenner B.M. From secondary to primary prevention of progressive renal disease: the case for screening for albuminuria. Kidney Int. 2004; 66: 2109-2118.
  3. ESH-ESC Guidelines Committee. ESH-ESC guidelines for the management of arterial hypertension. J. Hypertens. 2003; 21: 1011- 053.
  4. Комитет экспертов Российского медицинского общества по артериальной гипертонии и Всероссийского научного общества кардиологов. Диагностика и лечение артериальной гипертензии. Российские рекомендации (третий пересмотр). М., 2008.
  5. The ESH-ESC Task Force. 2007 Guidelines for the Management of the Arterial Hypertension. J. Hypertens. 2007; 25: 1105-1187.
  6. Schmieder R.E., Schrader J., Zidek W. et al. Low-grade albuminuria and cardiovascular risk: what is the evidence? Clin. Res. Cardiol. 2007; 96(5): 247-257.
  7. Arnlöv J., Evans J.C., Meigs J.B. et al. Low-grade albuminuria and incidence of cardiovascular disease events in nonhypertensive and nondiabetic individuals: the Framingham Heart Study. Circulation. 2005; 112(7): 969-975.
  8. Lieb W., Mayer B., Stritzke J. et al. Association of low-grade urinary albumin excretion with left ventricular hypertrophy in the general population: the MONICA/KORA Augsburg Echocardiographic Substudy. Nephrol. Dial. Transplant. 2006; 21(10): 2780-2787.
  9. Sung K.C., Kim B.J., Ryu S. An association of a variety of cardiovascular risk factors with low grade albuminuria in Korean men. Atherosclerosis. 2008; 196(1): 320-326.
  10. Wang T.J., Evans J.C., Meigs J.B. et al. Low-grade albuminuria and the risks of hypertension and blood pressure progression. Circulation. 2005; 111(11): 1370-1376.
  11. Ochodnicky P., Henning R.H., van Dokkum R.P., de Zeeuw D. Microalbuminuria and endothelial dysfunction: emerging targets for primary prevention of end-organ damage. Cardiovasc. Pharmacol. 2006; 47 (Suppl. 2): S151-S162.
  12. Tsakiris A., Doumas M., Lagatouras D. et al. Microalbuminuria is determined by systolic and pulse pressure over a 12-year period and related to peripheral artery disease in normotensive and hypertensive subjects: the Three Areas Study in Greece (TAS-GR). Angiology. 2006; 57 (3): 313-320.
  13. Metclaf P., Baker J., Scott A. et al. Albuminuria in people at least 40 years old: effect of obesity, hypertension and hyperlipidemia. Clin. Chem. 1992; 38: 1802-1808.
  14. Redon J., Miralles A., Pascual J.M. et al. Hyperinsulinemia as a determinant of microalbuminuria in essential hypertension. J. Hypertens. 1997;.15 (1): 79-86.
  15. Shankar S.S., Steinberg H.O. Obesity and endothelial dysfunction. Semin. Vasc. Med. 2005; 5: 56-64.
  16. Сагинова Е.А., Федорова Е.А., Фомин В.В. и др. Формирование поражения почек у больных ожирением. Тер. арх. 2005; 5: 36-41.
  17. Lekatsas I., Koulouris S., Triantafyllou K. et al. Prognostic significance of microalbuminuria in non-diabetic patients with acute myocardial infarction. Int. J. Cardiol. 2006; 106 (2): 218-223.
  18. Szczudlik A., Turaj W., Slowik A., Strojny J. Microalbuminuria and hyperthermia independently predict long-term.mortality in acute ischemic stroke patients. Acta Neurol. Scand. 2003; 107: 96-101.
  19. Terao Y., Miura K., Ichinomiya T. et al. Admission microalbuminuria and neurologic outcomes in intensive care unit.patients with spontaneous intracerebral hemorrhage. J. Neurosurg. Anesthesiol. 2008; 20(3): 163-168.
  20. Barzilay J.I., Fitzpatrick A.L., Luchsinger J. et al. Albuminuria and dementia in the elderly: a community study. Am. J. Kidney Dis. 2008; 52(2): 216-226.
  21. Wachtell K., Palmieri V., Olsen M.H. et al. Urine albumin/creatinine ratio and echocardiographic left ventricular structure and function in hypertensive patients with electrocardiographic left ventricular hypertrophy: the LIFE study. Losartan Intervention for Endpoint Reduction. Am. Heart J. 2002; 143(2): 319-326.
  22. Torun D., Sezer S., Arat Z. et al. The frequency of combined target organ damage and the beneficial effect of ambulatory blood pressure monitoring in never treated mild-to-moderate hypertensive patients. Int. Heart J. 2005; 46 (6): 1073-1082.
  23. Munakata M., Nunokawa T., Yoshinaga K. et al. Brachial-ankle pulse wave velocity is an independent risk factor for microalbuminuria in patients with essential hypertension - a Japanese trial on the prognostic implication of pulse wave velocity (J-TOPP). Hypertens. Res. 2006; 29(7): 515-521.
  24. Dalla Vestra M., Mussap M., Gallina P. et al. Acute-phase markers of inflammation and glomerular structure in patients with type 2 diabetes. J. Am. Soc. Nephrol. 2005; 16 (Suppl. 1): S78-S82.
  25. Färbom P., Wahlstrand B., Almgren P. et al. Interaction between renal function and microalbuminuria for cardiovascular risk in hypertension: the Nordic diltiazem study. Hypertension. 2008; 52(1): 115-122.
  26. Furtner M., Kiechl S., Mair A. et al. Urinary albumin excretion is independently associated with carotid and femoral artery atherosclerosis in the general population. Eur. Heart. J. 2005; 26: 279-287.
  27. Böhm M., Reil J.C., Danchin N. et al. Association of heart rate with microalbuminuria in cardiovascular risk patients: data from I-SEARCH. J. Hypertens. 2008; 26(1): 18-25.
  28. Boersma C., Postma M.J., Visser S.T. et al., PREVEND Study Group. Baseline albuminuria predicts the efficacy of blood pressure-lowering drugs in preventing cardiovascular events. Br. J. Clin. Pharmacol. 2008; 65(5): 723-732.
  29. Eguchi K., Matsui Y., Shibasaki S. et al. Changes in self-monitored pulse pressure correlate with improvements in B-type natriuretic peptide and urinary albumin in treated hypertensive patients. Am. J. Hypertens. 2007; 20(12): 1268-1275.
  30. Ibsen H., Olsen M.H., Wachtell K. et al. Reduction in albuminuria translates to reduction in cardiovascular events in hypertensive patients with left ventricular hypertrophy and diabetes. J. Nephrol. 2008; 21(4): 566-569.
  31. Cottone S., Mule G., Nardi E. et al. Microalbuminuria and early endothelial activation in essential hypertension. J. Hum. Hypertens. 2006;.36: 115-118.
  32. Dell'Omo G., Penno G., Giorgi D. et al. Association between high-normal albuminuria and risk factors for cardiovascular and renal disease in essential hypertensive men. Am. J. Kidney Dis. 2002; 40(1): 1-8.
  33. Delles C., Schmieder R.E. Renal endothelial effects of antihypertensive therapy. Curr. Opin. Nephrol. Hypertens. 2004; 13: 489-493.
  34. Parving H-H., Lehnert H., Brochner-Mortensen J. et al. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N. Engl. J. Med. 2001; 345: 870-878.
  35. Opie L.H., Parving H.-H. Diabetic nephropathy. Can renoprotection be extrapolated to cardiovascular protection? Circulation 2002; 106: 643-645.
  36. Persson F., Rossing P., Hovind P. et al. Irbesartan treatment reduces biomarkers of inflammatory activity in patients with type 2 diabetes and microalbuminuria: an IRMA 2 substudy. Diabetes. 2006; 55(12): 3550-3555.
  37. Llewelyn D.E., Garcia-Puig J. How different urinary albumin excretion rates can predict progression to nephropathy and the effect of treatment in hypertensive diabetics. J. Renin Angiotensin Aldosterone Syst. 2004; 5(3): 141-145.
  38. Rossing K., Christensen P.K., Andersen S. et al. Comparative effects of Irbesartan on ambulatory and office blood pressure: a substudy of ambulatory blood pressure from the Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria study. Diabetes Care. 2003; 26(3): 569-574.
  39. Persson F., Rossing P., Hovind P. et al. Endothelial dysfunction and inflammation predict development of diabetic nephropathy in the Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria (IRMA 2) study. Scand. J. Clin. Lab. Invest. 2008; 68(8): 731-738.
  40. Asselbergs F.W., Diercks G.F.H., Hillege H.L. et al. Effects of fosinopril and pravastatin on cardiovascular events in subjects with microalbuminuria. Circulation 2004; 110: 2809-2816.
  41. Hillege H.L., Janssen W.M., Bak A.A. et al. Microalbuminuria is common, also in a non-diabetic, non-hypertensive population, and an independent indicator of a cardiovascular risk factors and cardiovascular morbidity. J. Intern. Med. 2001; 249: 519-526.
  42. Mogensen.C.E. Twelve shifting paradigms in diabetic renal disease and hypertension. Diabetes Res. Clin. Pract. 2008; 82 (Suppl. 1): S2-S9.

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