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Microalbuminuria, indicated by total versus immunoreactive urinary albumins, in acute ischemic stroke patients

Peter Toth1, Akos Koller, Gabriella Pusch

  • 1Department of Physiology, New York Medical College, Valhalla, New York, USA.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|September 4, 2010
PubMed

Insights

Total urinary albumin (t-uAlb) is a more sensitive indicator of microalbuminuria in ischemic stroke patients than immunoreactive albumin (ir-uAlb). This finding suggests t-uAlb may improve stroke risk stratification and understanding of cerebrovascular disease.

Area of Science:

  • Nephrology
  • Neurology
  • Biochemistry

Background:

  • Microalbuminuria is prevalent in cerebrovascular disease and linked to stroke risk.
  • Current assessment relies on immunoreactive albumin (ir-uAlb), potentially underestimating prevalence.
  • Total urinary albumin (t-uAlb) includes both immunoreactive and nonimmunoreactive forms.

Purpose of the Study:

  • To evaluate if t-uAlb is a more sensitive marker for microalbuminuria in ischemic stroke patients compared to ir-uAlb.
  • To determine if t-uAlb correlates better with stroke severity and oxidative stress.
  • To investigate the prevalence of microalbuminuria using t-uAlb versus ir-uAlb.

Main Methods:

  • Urine samples from 98 ischemic stroke patients were analyzed.
  • Albumin-to-creatinine ratios (t-uAlb/uCreat and ir-uAlb/uCreat) were measured using HPLC and immunoturbidimetry.
  • Urinary ortho-tyrosine (o-Tyr/uCreat) and stroke severity (NIHSS) were assessed.

Main Results:

  • Microalbuminuria prevalence was significantly higher when detected by HPLC (66.3%) compared to immunoturbidimetry (36.7%).
  • Nonimmunoreactive albumin (nir-uAlb) was an independent predictor of stroke severity.
  • t-uAlb/uCreat and nir-uAlb/uCreat correlated significantly with oxidative stress markers (o-Tyr/uCreat), unlike ir-uAlb/uCreat.

Conclusions:

  • Total urinary albumin (t-uAlb) is a more sensitive indicator of microalbuminuria in acute ischemic stroke patients than ir-uAlb.
  • t-uAlb may offer improved diagnostic and prognostic value in cerebrovascular disease.
  • Further research is needed to clarify the mechanisms linking urinary albumins to stroke and their role in risk stratification.

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