High prevalence of microalbuminuria in chronic heart failure patients.
BACKGROUND
Microalbuminuria is associated with increased risk for cardiovascular morbidity and mortality. However, the relation between microalbuminuria and chronic heart failure has not been well described yet. In this cross-sectional study, we aim to evaluate the prevalence of microalbuminuria and the association with neurohormonal parameters in severe chronic heart failure patients.


RESULTS
We studied 94 stable chronic heart failure patients (New York Heart Association class III/IV) receiving therapy with angiotensin-converting enzyme (ACE) inhibitors for over three months. In all patients, renal function and neurohormonal status were evaluated and correlated with urinary albumin/creatinine ratio. The studied population consisted of 70 men and 21 women (mean age 69 +/- 12 years). Ischemia was the underlying cause of heart failure in 61 patients. Overall, 100% of the patients were treated with an ACE inhibitor, 72% with a beta-blocker, and 47% with spironolactone. In 32% (95% confidence interval 22-42) of the patients, microalbuminuria was present, which is significantly higher than in the general population. However, we found no significant association between the presence of microalbuminuria and renal function. Plasma NT-proBNP, active renin protein, angiotensin I, angiotensin II, and aldosterone did not differ significantly between groups with and without microalbuminuria.


CONCLUSIONS
In 32% of the patients, microalbuminuria was present. No association was found with either renal or neurohormonal parameters.
van de Wal
Ruud M A
RM
Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
Asselbergs
Folkert W
FW
Plokker
H W Thijs
HW
Smilde
Tom D J
TD
Lok
Dirk
D
van Veldhuisen
Dirk J
DJ
van Gilst
Wiek H
WH
Voors
Adriaan A
AA
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D000450:Aldosterone / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000809:Angiotensins / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006333:Heart Failure / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009426:Netherlands / Q000453:epidemiology; D010446:Peptide Fragments / Q000097:blood; D015995:Prevalence; D012083:Renin / Q000097:blood; D012107:Research Design; D013148:Spironolactone / Q000627:therapeutic use; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000809:Angiotensins; D015415:Biomarkers; D000451:Mineralocorticoid Receptor Antagonists; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D013148:Spironolactone; D000450:Aldosterone; D012083:Renin