An Observational Study of Correlation of Microalbuminuria with Target Organ Damage in Essential Hypertension

Abstract

Background: Hypertension is one of the most prevalent chronic conditions worldwide and a major contributor. It is a major modifiable risk factor for cardiovascular disease, stroke, heart failure, and renal impairment. The complications of hypertension are not confined to the cardiovascular system; target organ damage in the kidneys is of equal concern and is often silent until advanced stages. Microalbuminuria, defined as a urinary albumin excretion of 30–300 mg/24 hours, has been increasingly recognized as a sensitive and early indicator of renal involvement in hypertension. From a clinical perspective, detecting microalbuminuria provides an opportunity for early intervention. Methodology: This is study was conducted in the Department of General Medicine. 100 patients who match the inclusion and exclusion criteria have been selected by random sampling method and included in the study. Patients who were diagnosed with essential hypertension (already known or newly diagnosed) were selected from outpatient clinic and wards of tertiary care teaching hospital after applying inclusion and exclusion criteria. Results: Prevalence of microalbuminuria in this study was 33%. Distribution of microalbuminuria in different sex 35.2% males and 30.43% females had microalbuminuria. 54 patients were males and 46 patients were females out of 100 hypertensives. Microalbuminuria was present in 32.3% of non-smokers and 34.2% of smokers. 65 patients out of 100 were non-smokers and 35 patients were smokers. Out of 33 patients with microalbuminuria, 1 patient had normal fundus. 8 patients had grade 1 hypertensive retinopathy, 19 had grade 2 hypertensive retinopathy, 5 patients had grade 3 hypertensive retinopathy. This is statistically significant (p<0.00001). 22 people out of 35 patients with LVH on ECG had microalbuminuria. This is statistically significant (p<0.00001). 10 out of 56 patients with normal cardia on echocardiography had microalbuminuria and 23 out of 44 patients with LVH/cardiac dysfunction had microalbuminuria. This value is statistically significant. Conclusion: Microalbuminuria was detected in 33% of patients with essential hypertension, indicating its role as an early marker of target organ damage. A strong and statistically significant association was found between microalbuminuria and hypertensive retinopathy (fundus changes), left ventricular hypertrophy (LVH), and cardiac dysfunction on 2D-ECHO, highlighting its correlation with cardiovascular morbidity