title: Renal and cardiovascular risk predictive value of two different microalbuminuria screening methods in patients with hypertension with/without diabetes in Portugal.
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.
authors.affiliation: Department of Medicine, CINTESIS, Faculty of Medicine University of Porto, Hospital Pedro Hispano, Oporto, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Polónia
authors.affiliation: 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.
authors.forename: D
authors.initials: D
authors.lastname: Carvalho
authors.affiliation: Department of Cardiology, CHLO-Hospital de Egas Moniz, Lisbon, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Nazaré
authors.affiliation: Department of Cardiology, Hospital Santa Maria da Feira, Santa Maria da Feira, Portugal.
authors.forename: L
authors.initials: L
authors.lastname: Martins
authors.affiliation: Department of Internal Medicine, Arterial Investigation Unit, Hospital de Santa Marta, Lisbon, Portugal.
authors.forename: P M
authors.initials: PM
authors.lastname: da Silva
authors.affiliation: Department of Cardiology, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Aguiar
authors.affiliation: Faculty of Health Sciences, Universidade Fernando Pessoa, CIAGEB-UFP, REQUIMTE-Universidade do Porto, Oporto, Portugal.
authors.forename: M C
authors.initials: MC
authors.lastname: Manso
authors.affiliation: Medical Department, Novartis Farma, Porto Salvo, Portugal.
authors.forename: T
authors.initials: T
authors.lastname: Carqueja
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000175:diagnosis* / Q000453:epidemiology*; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D011174:Portugal / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D011320:Primary Health Care; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors; D016482:Urinalysis