title: The prevalence of albuminuria among diabetic patients in a primary care setting in Singapore.
abstract: BACKGROUND
  Microalbuminuria is an early sign of kidney damage. The prevalence of microalbuminuria in Singapore has been reported to be 36.0%-48.5%. However, the prevalence of microalbuminuria reported in these studies was determined with one urine sample using a qualitative urine test. The aim of this study was to determine the prevalence of micro- and macroalbuminuria using a more stringent criterion of two positive quantitative urine albumin-creatinine ratio (ACR) tests.
  
  
  METHODS
  We conducted a cross-sectional study of patients with type 2 diabetes mellitus (T2DM) who were followed up at a primary care clinic in Singapore. Patients were diagnosed to have albuminuria if they had two positive ACR tests within a seven-month period.
  
  
  RESULTS
  A total of 786 patients with T2DM met the study's inclusion criteria. 55.7% were already on an angiotensin-converting enzyme inhibitor (ACEI) and/or angiotensin receptor blocker (ARB). The prevalence rates of micro- and macroalbuminuria were 14.2% and 5.7%, respectively. Patients with albuminuria were more likely to have hypertension (odds ratio [OR] 3.47, 95% confidence interval [CI] 1.55-7.80). Diabetics with poorer diabetic control (OR 1.88, 95% CI 1.26-2.79), and higher systolic (OR 1.69, 95% CI 1.14-2.49) and diastolic (OR 1.96, 95% CI, 1.20 to 3.22) blood pressures were more likely to have albuminuria.
  
  
  CONCLUSIONS
  In the present study, the prevalence of microalbuminuria is significantly lower than that previously reported in Singapore. The presence of hypertension, poor diabetic control and suboptimal blood pressure control are possible risk factors for albuminuria in patients with T2DM.
authors.affiliation: Clinical Research Unit, Family Medicine Development Division, National Healthcare Group Polyclinics, Singapore.
authors.forename: Eng Sing
authors.initials: ES
authors.lastname: Lee
authors.affiliation: Clinical Research Unit, Family Medicine Development Division, National Healthcare Group Polyclinics, Singapore.
authors.forename: Wern Ee
authors.initials: WE
authors.lastname: Tang
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000150:complications / Q000453:epidemiology* / Q000652:urine; D001794:Blood Pressure; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011320:Primary Health Care; D012846:Singapore; D016896:Treatment Outcome
chemical_list: D003404:Creatinine
keywords: albuminuria; macroalbuminuria; microalbuminuria; prevalence; type 2 diabetes mellitus