Prevalence of microalbuminuria in hypertensive patients with or without type 2 diabetes in a Portuguese primary care setting: The RACE (micRoAlbumin sCreening survEy) study

Abstract

Introduction and Objectives To determine the prevalence of microalbuminuria (MAU) in outpatients with hypertension and/or type 2 diabetes mellitus (DM) and in normotensive, non-diabetic outpatients (control group); and, as secondary objectives, to examine the differences in the distribution of MAU in the four subgroups and the association of different clinical and epidemiological variables with MAU. Methods RACE (micRoAlbumin sCreening survEy) was a multicenter, descriptive observational cross-sectional study, which enrolled outpatients followed in primary care in Portugal. Patients with potential reasons for a false-positive MAU test were excluded. The main outcome measures were the prevalence of MAU as assessed by Micral ® test strips and blood pressure. Demographic variables, presence of comorbidities, use of cardiovascular and antidiabetic drugs and biochemical variables were also analyzed. Results A total of 9198 patients (3769 with hypertension, 3100 with both DM and hypertension, 423 with DM and without hypertension, and 1906 controls), 54.7% women, were included in the primary analysis. Overall prevalence of MAU was 58% in patients with DM and hypertension, 51% in patients with DM, 43% in patients with hypertension, and 12% in controls (chi-square: p<0.001 for all subgroups). In multivariate analysis, predictors for MAU were the presence of DM or hypertension, HbA1C, male gender, age, systolic blood pressure and total cholesterol. Conclusions MAU is extremely common in outpatients with DM and/or hypertension followed in primary care, especially in those with both hypertension and DM and high cardiovascular risk. MAU screening would help identify individuals at risk and increase awareness of kidney disease and target organ damage.