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Renal and cardiovascular risk predictive value of two different microalbuminuria screening methods in patients with hypertension with/without diabetes in Portugal

Journal of Human Hypertension volume 30, pages 726–730 (2016)Cite this article

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Abstract

MicRoAlbuminuria sCreening survEy (RACE) was a multicentre, observational, cross-sectional study conducted in primary health-care settings of Portugal. Here, we present a post-hoc analysis from the RACE study, assessing the renal and cardiovascular (CV) risk predictive value of two different microalbuminuria (MA) screening methods, nephelometry with 24-h urine (MA-24 h) and Micral test with occasional urine (MicralA) in patients with hypertension (HTN) with/without type 2 diabetes mellitus (T2DM). Out of 3065 patients, 1173 (38.3%) were in the HTN group without T2DM (HTN) and 1892 (61.7%) in the HTN group with T2DM (HTN+T2DM). The overall prevalence of MA was 50.6% determined by MicralA and 22.1% with MA-24 h. Urinary albumin excretion data obtained by both techniques correlated significantly (rs=0.586; P<0.001). In all subjects, MicralA showed a sensitivity of 93%, specificity of 62% for detection of MA, with a positive predictive value of 41% and negative predictive value of 97%. With both methods, the presence of MA was independently associated with a higher risk (1.5- to 2.9-fold) of CV and renal organ damage in both HTN and HTN+T2DM groups. MicralA, due to its high sensitivity and negative predictive value, can be considered as a valid and reliable method for MA screening in patients with HTN with/without T2DM.

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Acknowledgements

All authors participated in the development and writing of the paper and approved the final manuscript for publication. We take full responsibility for the content of the paper and thank Venkata S Bodla, Novartis Healthcare Pvt. Ltd., Hyderabad, India, for assisting in the writing of this manuscript, collating comments from all authors and editing the final manuscript. Thanks are also due to all the clinical investigators and study co-ordinators at the participating centres and all the patients who participated in this study. The study was funded by Novartis Farma Produtos Farmacêuticos SA.

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Authors and Affiliations

  1. Department of Medicine, CINTESIS, Faculty of Medicine University of Porto, Hospital Pedro Hispano, Oporto, Portugal

    J Polónia

  2. Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de S João, Faculty of Medicine University of Porto, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal

    D Carvalho

  3. Department of Cardiology, CHLO—Hospital de Egas Moniz, Lisbon, Portugal

    J Nazaré

  4. Department of Cardiology, Hospital Santa Maria da Feira, Santa Maria da Feira, Portugal

    L Martins

  5. Department of Internal Medicine, Arterial Investigation Unit, Hospital de Santa Marta, Lisbon, Portugal

    P M da Silva

  6. Department of Cardiology, Hospital de Santa Cruz, Carnaxide, Portugal

    C Aguiar

  7. Faculty of Health Sciences, Universidade Fernando Pessoa, CIAGEB-UFP, REQUIMTE—Universidade do Porto, Oporto, Portugal

    M C Manso

  8. Medical Department, Novartis Farma, Porto Salvo, Portugal

    T Carqueja

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  1. J Polónia
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Correspondence to J Polónia.

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Competing interests

TC is employed in Novartis Farma Produtos Farmacêuticos SA. The remaining authors declare no conflict of interest.

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Polónia, J., Carvalho, D., Nazaré, J. et al. Renal and cardiovascular risk predictive value of two different microalbuminuria screening methods in patients with hypertension with/without diabetes in Portugal. J Hum Hypertens 30, 726–730 (2016). https://doi.org/10.1038/jhh.2015.120

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