Microalbuminuria: a neglected cardiovascular risk factor in non-diabetic individuals?

Area of Science:

• Nephrology
• Cardiology
• Endocrinology

Background:

• Microalbuminuria (MA), defined as excessive albumin excretion in urine, is common in diabetes mellitus (DM) and hypertension.
• MA is associated with adverse renal and cardiovascular (CV) outcomes, including in specific populations like post-MI patients and hypertensives.

Purpose of the Study:

• To explore the association between microalbuminuria and cardiovascular risk.
• To investigate the relationship between microalbuminuria and hypertension.
• To evaluate the potential need for revising MA definitions based on CV risk.

Main Methods:

• Review of cross-sectional and prospective studies examining MA and CV outcomes.
• Analysis of associations between increased urine albumin excretion (UAE) and factors like left ventricular hypertrophy (LVH), atherosclerosis, metabolic syndrome (MetS), insulin resistance (IR), and obesity.
• Evaluation of existing evidence on UAE thresholds and CV risk.

Main Results:

• MA prevalence is higher in patients with DM and/or hypertension.
• Increased UAE is linked to adverse renal and CV outcomes, LVH, atherosclerosis markers, vascular dysfunction, MetS, IR, inflammation, lipids, and obesity.
• Evidence suggests UAE levels below traditional MA thresholds are associated with increased CV risk.

Conclusions:

• Microalbuminuria is a significant predictor of adverse cardiovascular outcomes, particularly in diabetic and hypertensive individuals.
• Current definitions of MA may not fully capture the spectrum of cardiovascular risk.
• Further research with standardized methodologies is needed to refine MA definitions and its role as a CV risk predictor.