[Microalbuminuria in nondiabetic adults]

This paper deals with the clinical relevance of moderate increase in urinary albumin excretion, commonly known as microalbuminuria, in non-diabetic adults. Presently there are several definitions of microalbuminuria. When measuring excretion rates, microalbuminuria is defined by thresholds of 30 mg/day or 20 g/min with urine collections shorter than 24 hours whereas macroalbuminuria is defined by rates higher than 300 mg/day or micro 200 g/min, respectively. Clinical and epidemiological data indicate the presence of a correlation between blood pressure and microalbuminuria. Microalbuminuria is progressively more frequent with higher blood pressure (systolic or diastolic) also in non-hypertensive persons. Antihypertensive drugs lower urinary albumin excretion, the effect is modest or absent for dihydropyridinic calcium-channel blockers, strong for inhibitors of the renin-angiotensin system. In addition to blood pressure, other factors directly related to urinary excretion of albumin are cigarette smoking, blood lipids, body mass and dietary protein. In non-diabetics, microalbuminuria anticipates lethal and non-lethal cardiovascular events. This correlation can also be observed in the range of urinary albumin excretion below the thresholds that define microalbuminuria. Present data are not consistent on the possible correlation between microalbuminuria and renal function in non-diabetics.