Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0730345 (microalbuminuria)
4,018 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several reports suggest that urinary albumin excretion may be elevated in patients with essential hypertension and that this index may be a good predictor for cardiovascular complications. The aim of this study was to compare 24-hour urinary albumin excretion in a group of normotensives, borderline, and untreated mild hypertertensives and to assess, in a subgroup of them, the possible relations between microalbuminuria and arterial blood pressure. Fifteen normotensives, 16 borderline, and 19 mild hypertensive patients were studied. Slightly but significantly higher values of microalbuminuria were observed in the mild hypertensives compared to the other two groups. In 21 borderline and mild hypertensive patients 24-hour microalbuminuria was related to casual blood pressure and noninvasive ambulatory blood pressure monitoring. A significant correlation was found between microalbuminuria and average day-time diastolic blood pressure. Our data suggest that albumin excretion is slightly increased in mild arterial essential hypertension; the direct association between microalbuminuria and arterial diastolic blood pressure during daily activities seems to confirm a pathophysiological link between transcapillary protein escape and arterial blood pressure that warrants further studies.
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PMID:Microalbuminuria and casual and ambulatory blood pressure monitoring in normotensives and in patients with borderline and mild essential hypertension. 270 93

Within hypertensive populations, the risk of future cardiovascular complications and of death varies substantially according to the risk factor profile of the hypertensive subject. In primary hypertension, significant renal insufficiency is rarely observed, whereas proteinuria can be observed at various frequencies according to the method of analysis and severity of hypertension. The incidence of clinically apparent proteinuria varies between 4 and 16% in different hypertensive patient series. One prospective observational, epidemiological study has clearly shown that proteinuria is an important, independent predictor of both mortality and cardiovascular morbidity in an untreated population. Two large studies of hypertensive populations treated for 4 and 10 years, respectively, have shown that clinically apparent proteinuria remains as an independent predictor of death and cardiovascular morbidity in treated patients. A third long term study suggests that 'microalbuminuria' (i.e. subclinical urinary albumin excretion), if present at start of therapy, also has an important prognostic meaning during long term follow-up. However, it is not yet known whether a reduction and normalisation of the urinary excretion of albumin during long term treatment will also be associated with an improved prognosis.
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PMID:Proteinuria as a prognostic factor during long term hypertensive care. 306 85

The relation between hypertension and diabetic nephropathy is complex. Nephropathy is probably involved in the elevated blood pressure found in diabetic patients. In maturity onset diabetes, patients may also have hypertension which is associated with obesity or essential hypertension. It has been suggested that in both types of diabetes, hypertension enhances the development of diabetic nephropathy. Moreover, an aggressive antihypertensive treatment seems able to reduce rate of decline in kidney function in insulin-dependent diabetic patients with patent nephropathy. In this work, creatinine clearance and microalbuminuria in 20 diabetic patients (mostly with maturity-onset-diabetes) with known moderate and effectively treated hypertension were therefore measured and the results were compared with those for 18 normotensive diabetic patients and 22 controls. Duration of diabetes was from one to 26 years (mean: 11 years) and duration of hypertension was from one to 35 years (mean: 10 years). Patients and controls had normal serum creatinine and proteinuria below 0.1 g/l. Microalbuminuria was measured by immunonephelometric assay using specific antiserum (sensitivity = 1.5 mg/l; intra and interassay coefficients: 6.5% and 8% respectively). The highest value was observed in hypertensive diabetic patients with retinopathy (group 1). But hypertensive patients without retinopathy (group 2) and normotensive patients also had significantly increased microalbuminuria. In group 1, microalbuminuria was significantly higher than in group 2. The creatinine clearance was reduced in groups 1 and 2 versus normotensive diabetics, but hypertensive patients were older.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Microalbuminuria in diabetics with moderate hypertension]. 309 93

The principles and difficulties of enzyme diagnosis of myocardial infarction, differential diagnostic significance of a study of isoenzymatic activity, and some difficulties of topical diagnosis on the basis of enzymatic tests were considered the light of modern methods of clinical biochemistry. The necessity of enzyme diagnosis was assessed and substantiated. It was shown that the problems of pathobiochemistry of coronary heart disease were not limited to lipoprotein metabolic derangements only; the diagnostic importance of a HDL cholesterol value was assessed. The diagnostic importance of microalbuminuria and the activity of N-acetyl-beta-glucoaminidase in the diagnosis of essential hypertension and symptomatic hypertension was underlined.
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PMID:[Clinical evaluation of biochemical diagnostic studies]. 321 21

The purpose of the study was to compare the effect of treatment with an angiotensin converting enzyme inhibitor (Lisinopril, MSD) or calcium blocker (Nifedipine retard, MSD) treatment during three months on blood pressure (measured with sphygmomanometric method and ambulatory blood pressure monitoring--ABPM) and urinary albumin excretion in essential hypertension class I acc. to WHO. Fifteen untreated patients aged 38 +/- 5 years with essential hypertension participated in the study and received diet with normal sodium content. Urinary albumin excretion was measured by RIA method in two 24 hour urine collections and mean value was calculated. ABPM was measured with Spacelabs monitor. After first examination 8 patients were randomly selected for the treatment with lisinopril and 7 patients to the treatment with nifedipine. The doses of both drugs were gradually adjusted to reach diastolic blood pressure below 90 mmHg. After 3 months of treatment urinary albumin excretion and blood pressure was found in both after treatment in patients treated with lisinopril but not in those receiving nifedipine. In patients treated with lisinopril a correlation between the decrease in systolic and diastolic blood pressure (measured by ABPM) and decrease of urinary albumin excretion was demonstrated. It was concluded that the normalization of blood pressure induced by lisinopril treatment in patients with uncomplicated essential hypertension and normoalbuminuria is accompanied with significant diminution of urinary albumin excretion which suggests preventive action of the drug in the development of microalbuminuria. Diminution of urinary albumin excretion caused by lisinopril is probably due to both the decrease of blood pressure and the specific renal action of the drug.
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PMID:[Comparison of treatment effects with an angiotensin converting enzyme inhibitor--lisinopril and a calcium blocker--nifedipine retard on urinary albumin excretion in patients with non-complicated essential hypertension]. 747 31

One hundred nine patients with essential hypertension and without either diabetes mellitus or clinical proteinuria were examined to investigate possible racial differences in urinary albumin excretion rates. The black hypertensive patients were found to have significantly higher urinary albumin excretion rates compared with the white patients; in addition, a significantly greater proportion of the black patients than the white patients (32% v 14%) had microalbuminuria, defined as a urinary albumin excretion rate greater than 30 micrograms/min. These differences could not be explained by age, blood pressure, body mass index, glycosylated hemoglobin, serum creatinine, duration of hypertension, or type of hypertension treatment. Hypertensive renal failure occurs six to 18 times more frequently in blacks than in whites; to our knowledge, these data are the first to indicate that microalbuminuria may be more prevalent during the course of hypertension in black patients and thus may be an early marker for end-organ damage susceptibility among hypertensive patients.
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PMID:Racial differences in the prevalence of microalbuminuria in hypertension. 757 9

To investigate the metabolic and renal effects of the nonsulfhydryl, tissue-active ACE inhibitor quinapril in diabetes and in hypertension, we studied 30 essential hypertensives and 24 non-insulin-dependent (type II) diabetic (NIDDM) subjects with hypertension. Systolic and diastolic blood pressures, plasma glucose, and insulin responses to an oral glucose load (75 g), lipid profile, and urinary albumin excretion were evaluated before and after 8 weeks' administration of quinapril (10 to 40 mg/day). Quinapril produced a significant and comparable reduction of arterial blood pressure in both groups. Mean arterial pressure decreased from 114.8 +/- 0.9 to 94.2 +/- 1.1 (-17.9 +/- 1.5%) in the essential hypertensive group and from 118.4 +/- 1.6 to 96.2 +/- 1.4 (-18.4 +/- 1.6%) in the diabetic hypertensive group. In both essential hypertensives and diabetic-hypertensive subjects with microalbuminuria, quinapril significantly and comparably reduced the urinary albumin excretion rate (UAE); UAE decreased from 32.5 +/- 5.5 micrograms/min to 14.7 +/- 3.7 micrograms/min (P < .05 v baseline) in the diabetic-hypertensive group and from 27.5 +/- 3.0 micrograms/min to 11.6 +/- 2.7 micrograms/min (P < .05 v baseline) in the essential hypertensives. Altogether, a direct correlation was found between the initial level of UAE and the UAE reduction after quinapril (delta UAE) (r = 0.706, p < .05). Insulin and glucose responses to an oral glucose tolerance test and the lipid profiles were not modified by quinapril treatment. The results confirm that quinapril is an effective antihypertensive agent that additionally reduces microalbuminuria in both hypertensive diabetics and in patients with essential hypertension, without altering insulin sensitivity and lipid profiles.
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PMID:Quinapril reduces microalbuminuria in essential hypertensive and in diabetic hypertensive subjects. 757 97

Microalbuminuria is defined as urinary excretion of albumin that is persistently above normal, although below the sensitivity of conventional semiquantative test strips. Several studies have reported that Type 1 diabetic patients with microalbuminuria are apparently more likely to develop diabetic nephropathy eventually progressing to renal failure. Microalbuminuria is also a strong predictor of mortality in Type 2 diabetes, and is correlated with increased blood pressure in patients with benign essential hypertension. Radioimmunoassay revealed a significantly higher urinary albumin excretion rate in normal pregnant women in the third trimester of pregnancy, compared to the second and first, and compared to non-pregnant women. Microalbuminuria was found in 30% of women who had a record of gestational diabetes mellitus. Published results are controversial regarding the assumption that microalbuminuria is an early predictor of pregnancy-induced hypertensive complications.
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PMID:Microalbuminuria: prognostic and therapeutic implications in diabetic and hypertensive pregnancy. 758 1

Microalbuminuria in patients with essential hypertension is a marker of incipient glomerular dysfunction and clusters with lipid and hemodynamic abnormalities. Recent evidence has shown that hypertensive patients with microalbuminuria have a hyperinsulinemic response to oral glucose, suggesting the presence of insulin resistance. To directly test this possibility we studied insulin action in two accurately matched groups (n = 10 each) of hypertensive patients with or without microalbuminuria (14 +/- 2 versus 52 +/- 7 mg/24 h-1, mean of three 24-hour collections). In response to glucose ingestion microalbuminuric patients showed slight hyperglycemia (area under the curve, 928 +/- 43 versus 784 +/-19 nmol/L-1/2h-1, P < .02) and a marked hyperinsulinemia (26.8 +/- 3.3 versus 49.8 +/- 3.7 nmol/L-1/2h-1, P < 0.01). Basal arterial blood pressure, heart rate, and forearm blood flow were similar in the two groups and did not change significantly during a 2-hour euglycemic insulin clamp. Insulin-stimulated wholebody glucose uptake was 25% lower in microalbuminuric patients (33.5 +/- 2.5 versus 25.2 +/- 2.1 mumol/min-1/kg-1, P < .02). This difference was entirely due to a 40% reduction in glycogen synthesis (12.9 +/- 1.8 versus 21.3 +/- 3.2 mumol/min-1/kg-1, P < .05) as glucose oxidation was similarly stimulated in the two groups. In contrast there was no difference in the ability of insulin to suppress hepatic glucose production (by approximately 100% at the end of the clamp), to decrease fractional sodium and potassium excretions (by 35%), to lower circulating free fatty acids (by 80%), and to reduce plasma potassium concentrations (by 10%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Insulin resistance in microalbuminuric hypertension. Sites and mechanisms. 759 Oct 19

A growing interest in the study of microalbuminuria (Mi) in essential hypertension (EH) has recently emerged. While clinical proteinuria is found with a low frequence (between 4 and 16%) in patients with EH, a variable but generally higher prevalence (10-40%) of Mi has been reported, even in the absence of diabetes and nephropathy. Mi is defined as an abnormal urinary excretion of albumin (20-200 micrograms/min), undetectable by conventional tests. Variations in the prevalence of Mi in different studies may be attributed to different selection criteria, techniques for detection of albuminuria, the severity of hypertension, age, race, coexistence of renal disease as well as the number of patients studied and the presence or absence of antihypertensive treatment. It is unknown whether the predictive value of albuminuria reflects its association with more severe hypertension and target organ damage, or whether albuminuria serves as an indicator of capillary leakiness which causes detectable abnormalities in the renal microcirculation but reflects more generalized endothelial barrier dysfunction predisposing to accelerated atherogenesis. Mi has been associated with higher blood pressure levels, a worse lipid profile as well as the presence of target organ damage, namely peripheral artery disease and left ventricular hypertrophy in patients with EH. Several studies have shown a correlation between Mi and/or proteinuria and cardiovascular diseases independently of other risk factors and cardiovascular mortality to be ten times higher in patients with Mi than in normoalbuminuric patients. Long-term prospective studies are needed in order to clarify the exact prevalence of Mi, its predictive value for the development of clinical proteinuria and renal function deterioration as well as the effect of different antihypertensive drugs.
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PMID:[Microalbuminuria, hypertension, and cardiovascular risk]. 763 60


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