Central European Journal of Medicine

, Volume 8, Issue 3, pp 302–309 | Cite as

Intensive treatment of persistent microalbuminuria: determinants of treatment resistance

  • Nicolas Roberto Robles
  • Joaquin Velasco
  • Candido Mena
  • Enrique Angulo
  • the MICREX Group Investigators
Research Article



Persistent microalbuminuria after treatment is a common finding. This study tried to evaluate the causes of treatment resistance.

Patients and methods

Sample: 204 patients treated with renina-angiotensin-axis (RAA) blocking drugs that showed positive microalbuminuria. Treatment was increased during three months to reach a BP < 130/80 mmHg and to obtain maximal RAA blockade. Then patient were classified as normoalbuminuric after treatment (N group) and microalbuminuric in spite of treatment (M).


Mean microalbuminuria at recruitment was 48.5±25.6 mg/24h in N group and 90.0±140.3 mg/24h in M group. It was reduced to 16.1±10.0 mg/day in N group and to 83.5±138.2 mg/day in M group. At start, mean SBP and mean DBP were not different between groups. After treatment SBP and DBP pressure were reduced in both groups (differences between groups were not significant). Combined control of BP showed a slight increase in the two groups but it have only statistical significance in the N group (p = 0.031, McNemar test).


Persistent microalbuminuria seems to be associated to poor blood pressure control. Effective blood pressure reduction was followed by urinary albumin excretion decrease. Baseline severity of microalbuminuria was the only clear predictor of remission after treatment.


Microalbuminuria Hypertension Remission Response to treatment 


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Copyright information

© Versita Warsaw and Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Nicolas Roberto Robles
    • 1
  • Joaquin Velasco
    • 2
  • Candido Mena
    • 3
  • Enrique Angulo
    • 4
  • the MICREX Group Investigators
  1. 1.Cátedra de Riesgo CardiovascularFacultad de Medicina Universidad de SalamancaSalamancaSpain
  2. 2.Centro de Salud Mérida NorteMéridaSpain
  3. 3.Centro de Salud Jose Maria AlvarezDon BenitoSpain
  4. 4.Centro de Salud Ciudad JardinBadajozSpain

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