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Urinary microalbumin as a marker for intermittent claudication
M Matsushita1, N Nishikimi, T Sakurai
1First Department of Surgery, Nagoya University, School of Medicine, Japan.
Objective:
The urinary microalbumin concentration was analysed in patients with intermittent claudication in order to investigate its usefulness as a marker for intermittent claudication.
Materials And Methods:
Urinary samples were collected prior to and following exercise in 15 patients with claudication. The patients walked on a treadmill as far as possible until they were stopped by pain. Urinary microalbumin concentration was measured by a latex agglutination system, and the result was considered abnormal when the concentration exceeded 10 mg/g creatinine. The ankle brachial pressure index (ABI) at rest and the time taken for the ankle pressure to return to the resting level following exercise (ABI recovery time) also were measured.
Results:
In seven (47%) of the patients, the urinary microalbumin concentration was elevated to more than 10 mg/g creatinine following exercise, while in eight (53%) it remained normal. The ABI recovery time was significantly longer in the patients in whom the microalbumin concentration was elevated, compared to that in patients without an elevated concentration. The urinary microalbumin concentration following exercise was reduced significantly when the walking distance was decreased 50% or 15%. Following vascular bypass surgery, the elevation in urinary microalbumin concentration was reduced.
Conclusions:
The use of urinary microalbumin as a diagnostic marker for intermittent claudication is limited. However, in cases where the concentration is elevated, it can be used to follow the course of the disease.
Insights
Urinary microalbumin may not diagnose intermittent claudication but can monitor disease progression. Elevated levels after exercise correlate with longer recovery times and improve with treatment.
Area of Science:
- Vascular Medicine
- Nephrology
- Biomarker Research
Background:
- Intermittent claudication (IC) is a common symptom of peripheral artery disease.
- Early detection and monitoring of IC are crucial for effective management.
- Urinary microalbumin has been explored as a potential biomarker for vascular conditions.
Purpose of the Study:
- To evaluate the utility of urinary microalbumin concentration as a marker for intermittent claudication.
- To assess the relationship between urinary microalbumin levels and exercise-induced symptoms in IC patients.
Main Methods:
- Collected pre- and post-exercise urine samples from 15 IC patients.
- Measured urinary microalbumin concentration using a latex agglutination system.
- Assessed ankle brachial pressure index (ABI) and ABI recovery time post-exercise.
Main Results:
- 47% of patients showed elevated urinary microalbumin post-exercise.
- Elevated microalbumin correlated with significantly longer ABI recovery times.
- Microalbumin levels decreased with reduced walking distance and after vascular bypass surgery.
Conclusions:
- Urinary microalbumin has limited diagnostic value for intermittent claudication.
- Elevated urinary microalbumin can serve as a valuable indicator for monitoring disease progression in IC patients.
- Changes in microalbumin levels may reflect treatment efficacy.
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