title: Distribution pattern of urine albumin creatinine ratio and the prevalence of high-normal levels in untreated asymptomatic non-diabetic hypertensive patients.
abstract: BACKGROUND
  Even high-normal albuminuria is reportedly associated with cardiovascular events.
  
  
  OBJECTIVE
  We determined the urine albumin creatinine ratio (UACR) in spot urine samples and analyzed the UACR distribution and the prevalence of high-normal levels.
  
  
  METHODS
  The UACR was determined using immunoturbidimetry in 332 untreated asymptomatic non-diabetic Japanese patients with hypertension and in 69 control subjects. The microalbuminuria and macroalbuminuria levels were defined as a UCAR ≥30 and <300 µg/mg·creatinine and a UCAR ≥300 µg/mg·creatinine, respectively.
  
  
  RESULTS
  The distribution patterns showed a highly skewed distribution for the lower levels, and a common logarithmic transformation produced a close fit to a Gaussian distribution with median, 25th and 75th percentile values of 22.6, 13.5 and 48.2 µg/mg·creatinine, respectively. When a high-normal UACR was set at >20 to <30 µg/mg·creatinine, 19.9% (66/332) of the hypertensive patients exhibited a high-normal UACR. Microalbuminuria and macroalbuminuria were observed in 36.1% (120/336) and 2.1% (7/332) of the patients, respectively. UACR was significantly correlated with the systolic and diastolic blood pressures and the pulse pressure. A stepwise multivariate analysis revealed that these pressures as well as age were independent factors that increased UACR.
  
  
  CONCLUSIONS
  The UACR distribution exhibited a highly skewed pattern, with approximately 60% of untreated, non-diabetic hypertensive patients exhibiting a high-normal or larger UACR. Both hypertension and age are independent risk factors that increase the UACR. The present study indicated that a considerable percentage of patients require anti-hypertensive drugs with antiproteinuric effects at the start of treatment.
authors.affiliation: Department of Medical Technology, Okayama University Graduate School of Health Sciences, Japan.
authors.forename: Natsuki
authors.initials: N
authors.lastname: Ohmaru
authors.forename: Takaaki
authors.initials: T
authors.lastname: Nakatsu
authors.forename: Reishi
authors.initials: R
authors.lastname: Izumi
authors.forename: Keiichi
authors.initials: K
authors.lastname: Mashima
authors.forename: Misako
authors.initials: M
authors.lastname: Toki
authors.forename: Asako
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ogawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirohata
authors.forename: Satoru
authors.initials: S
authors.lastname: Ikeda
authors.forename: Shozo
authors.initials: S
authors.lastname: Kusachi
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology* / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D003404:Creatinine / Q000652:urine*; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D015415:Biomarkers; D003404:Creatinine