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Prevalence of proteinuria/microalbuminuria in an elderly urban, biethnic community

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Geriatric Nephrology and Urology

Abstract

Introduction. The purpose of this study was to compare the prevalences of urinary abnormalities, notably proteinuria and microalbuminuria, in a randomly selected, biethnic population of Hispanic and nonHispanic white males and females and to determine the effects of diabetes, hypertension, and coronary heart disease on these prevalence rates. Methods. A survey of health and health related issues was conducted on 883 volunteers, mean age 74.1 years, selected randomly from the Medicare rolls of Bernallilo County (Albuquerque), New Mexico. The sample consisted of nearly equal numbers of Hispanic and nonHispanic white males and females. A dipstick urinalysis and test for microalbuminuria was performed on a clean void, untimed urine sample as a part of a 4-hour interview/examination. Results. Of the 696 participants with complete databases, 10.5% had 1+ or greater proteinuria (30 mg/dL or more) by convential urinalysis dipstick and 19.8% had microalbuminuria (50 mg/L or more) by Micral Chemstrip® methodology. Participants with diabetes mellitus (Odds Ratio (OR) 2.54, Confidence Interval (CI) 1.71–3.76, p < 0.001), and/or hypertension (OR 2.09, 95% CI 1.46–3.01, p < 0.001) were more likely to have microalbuminuria than participants without either of these conditions. After adjusting for the presence of diabetes and hypertension, there was a trend toward an increased prevalence of coronary heart disease (OR 1.23, 95% CI 0.84–1.81 p = 0.28) in those with microalbuminuria, but this did not reach levels of statistical significance. Conclusions. Hispanics, even after adjusting for a higher prevalence of diabetes, and for small differences in prevalences of hypertension and coronary heart disease, had more microalbuminuria than nonHispanic whites, and males had more microalbuminuria than females.

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References

  1. Parving H-H. Microalbuminuria in essential hypertension and diabetes mellitus. J Hypertension 1996; 14(suppl 2): S89-S94.

    CAS  Google Scholar 

  2. Marshall SM, Shearing PA, Alberti KGMM. Micral-test strips evaluated for screening of albuminuria. Clin Chem 1992; 38: 588-591.

    PubMed  CAS  Google Scholar 

  3. Alzaid AA. Microalbuminuria in patients with NIDDM: An overview. Diabetes Care 1996; 19: 79-89.

    PubMed  CAS  Google Scholar 

  4. Smulders YM, Rakic M, Stehouwer CDA, Weijers RNM, Sloats EH, Sibverbush J. Determinants of progression of microalbuminuria in patients with NIDDM. A prospective study. Diabetes Care 1997; 20: 999-1005.

    PubMed  CAS  Google Scholar 

  5. Schmitz A, Vaeth M, Mogensen CE. Systolic blood pressure relates to the rate of progression of albuminuria in NIDDM. Diabetologia 1994; 37: 1251-1258.

    PubMed  CAS  Google Scholar 

  6. Agewall S, Wikstrand J, Ljungman S, Fagerberg B. Usefulness of microalbuminuria in predicting cardiovascular mortality in treated hypertensive men with and without diabetes mellitus. Am J Cardiol 1997; 80: 164-169.

    Article  PubMed  CAS  Google Scholar 

  7. Niskanen LK, Penttila I, Parvianen M, Uusitupa MIJ. Evaluation, risk factors and prognostic implications of albuminuria in NIDDM. Diabetes Care 1996; 19: 486-493.

    PubMed  CAS  Google Scholar 

  8. Haffner SM, Stern MP, Gruber KK, Hazuda HP, Mitchell BD, Patterson JK. Microalbuminuria. Potential marker for increased cardiovascular risk factors in nondiabetic subjects. Atherosclerosis 1990; 10: 727-731.

    CAS  Google Scholar 

  9. Savage S, Estacio RO, Jeffers B, Schrier RW. Urinary albumin excretion as a predictor of diabetic retinopathy, neuropathy, and cardiovascular disease in NIDDM. Diabetes Care 1996; 19: 1243-1248.

    PubMed  CAS  Google Scholar 

  10. Dineen SF, Gerstein HC. The association of microalbuminuria and mortality in non insulin-dependent diabetes mellitus. A systematic overview of the literature. Arch Intern Med 1997; 157: 1413-1418.

    Article  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  12. Heidenreich S, Zierden E, Zidek W. Microalbuminuria in very old patients. Geriatric Nephrol Urol 1995; 5: 9-13.

    Article  Google Scholar 

  13. Gatling W, Knight C, Hill RD. Screening for early diabetic nephropathy: which sample to detect microalbuminuria? Diabetic Med 1985; 2: 451-455.

    PubMed  CAS  Google Scholar 

  14. Cowell CT, Rodgers S, Silkink M. First morning urinary albumin concentration is a good predictor of 24-hour urinary albumin excretion in children with type 1 (insulin-dependent) diabetes. Diabetologia 1986; 29: 97-99.

    Article  PubMed  CAS  Google Scholar 

  15. Haffner SM, Gonzales C, Valdes RA, Mykkanen L, Hazuda HP, Mitchell BD, Monterosa A, Stern MP. Is microalbuminuria part of the prediabetic state? The Mexico City Diabetes Study. Diabetologia 1993: 36: 1002-1006.

    Article  PubMed  CAS  Google Scholar 

  16. Lindeman RD, Romero LJ, Hundley R, Allen AS, Liang HC, Baumgartner RN, Koehler KM, Schade DS, Garry PJ. Prevalence of type 2 diabetes, the insulin resistance syndrome, and coronary heart disease in an elderly, biethnic population. Diabetes Care 1998; 21: 959-966.

    PubMed  CAS  Google Scholar 

  17. Baumgartner RN, Koehler K, Romero L, Garry PH, Lindeman RD. Muscle mass and obesity are jointly associated with disability, impaired balance and gait, and falls in elderly men and women. Am J Epidemiol 1998; 147: 755-763.

    PubMed  CAS  Google Scholar 

  18. Katz D, Baptista J, Azen SP, Pike MC. Obtaining confidence intervals for the risk ratio in cohort studies. Biometrics 1978; 34: 469-474.

    Article  Google Scholar 

  19. SAS User's Guide. Basics, version 6.10 edition. Cary, NC: SAS Institute, Inc., 1995.

  20. Kannel WB, Stampfer MY, Castelli WP, Verter J. The prognostic significance of proteinuria: the Framingham study. Am Heart J 1984; 108: 1347-1352.

    Article  PubMed  CAS  Google Scholar 

  21. Samuelson O, Wilhelmsen L, Elmfeldt D, Pennert K, Wedel H, Wikstrand J, Berglund G. Predictors of cardiovascular morbidity in treated hypertension: results from the primary preventive trial in Goteborg, Sweden. J Hypertension 1985; 3: 167-176.

    Google Scholar 

  22. Mogensen CE. Microalbuminuria predicts clinical proteinuria and early mortality in maturity onset diabetes. N Engl J Med 1984; 310: 60.

    Article  Google Scholar 

  23. Jarrett RJ, Viberti GC, Argyropoulos A, Hill RD, Mahmud U, Murrells TJ. Microalbuminuria predicts mortality in noninsulin dependent diabetes. Diabetic Med 1984; 1: 17-20.

    PubMed  CAS  Google Scholar 

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

    Article  Google Scholar 

  25. Yudkin JS, Forrest RD, Jackson CA. Microalbuminuria as a predictor of vascular disease in non-diabetic subjects. Islington diabetes survey. Lancet 1988; 2: 530-533.

    Article  PubMed  CAS  Google Scholar 

  26. Jensen JEB, Nielson SH, Foged L, Holmegaard SN, Magid E. TheMicral® test for diabetic microalbuminuria: predictive values as a function of prevalence. Scand J Clin Lab Invest. 1996; 56: 117-122.

    PubMed  CAS  Google Scholar 

  27. Winocour PH, Harland J, Millar JP, Laker MF, Alberti KGMM. Microalbuminuria and associated risk factors in the community. Atherosclerosis 1992; 93: 71-81.

    Article  PubMed  CAS  Google Scholar 

  28. Damsgaard EM, Mogensen CE. Microalbuminuria in elderly hyperglycemic patients and controls. Diabetic Med 1986; 3: 430-435.

    Article  PubMed  CAS  Google Scholar 

  29. Haffner SM, Mitchell BD, Pugh JA, Stern MP, Kozlowski MK, Hazuda HP, Patterson JK, Klein R. Proteinuria in Mexican Americans and non-Hispanic whites. Diabetes Care 1989; 12: 530-536.

    PubMed  CAS  Google Scholar 

  30. Hamman RF, Franklin GA, Mayer EJ, Marshall SM, Marshall JA, Baxter J, Kahn LB. Microvascular complications of NIDDM in Hispanics and non-Hispanic whites. Diabetes Care 1991; 14: 655-663.

    PubMed  CAS  Google Scholar 

  31. Deckert T, Feldt-Rassmussen B, Borch-Johnsen K, Jensen T, Kofoed-Enevoldsen A. Albuminuria reflects widespread vascular damage. The Steno hypothesis. Diabetologia 1988; 32: 219-226.

    Article  Google Scholar 

  32. Jones SL, Close CF, Mattock MB, Jarrett RJ, Keen H, Viberti GC. Plasma lipid and coagulation factor concentrations in insulin dependent diabetics with microalbuminiuria. BMJ 1989; 298: 487-490.

    Article  PubMed  CAS  Google Scholar 

  33. Kuuisto J, Mykkänen L, Pyörälä, Laakso M. Hyperinsulinemic microalbuminuria: a new risk indicator for coronary heart disease. Circulation 1995; 91: 831-837.

    Google Scholar 

  34. Niskanen L, Laakso M. Insulin resistance is related to albuminuria in patients with type II (non-insulin-dependent) diabetes mellitus. Metabolism 1993; 42: 1541-1545.

    Article  PubMed  CAS  Google Scholar 

  35. American Diabetes Association. Consensus development conference on the diagnosis and management of nephropathy in patients with diabetes mellitus. Diabetes Care 1994; 17: 1357-1361.

    Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, University of New Mexico Hospital, Albuquerque, New Mexico, USA

    Robert D. Lindeman, Linda Romero, Hwa Chi Liang, Rosalina Hundley, Richard Baumgartner, Kathleen Koehler & Philip Garry

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  1. Robert D. Lindeman
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  2. Linda Romero
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  3. Hwa Chi Liang
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  4. Rosalina Hundley
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  5. Richard Baumgartner
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  6. Kathleen Koehler
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  7. Philip Garry
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Lindeman, R.D., Romero, L., Liang, H.C. et al. Prevalence of proteinuria/microalbuminuria in an elderly urban, biethnic community. Geriatric Nephrology and Urology 8, 123–130 (1998). https://doi.org/10.1023/A:1008361406004

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