EPIDEMIOLOGY OF MICROALBUMINURIA IN THE GENERAL-POPULATION

Microalbuminuria in the general population is associated with recogniz ed risk factors for cardiovascular disease such as hypertension hyperg lycemia, hyperinsulinemia, and hyperlipidemia; and it is an independen t predictor of subsequent cardiovascular mortality in hypertensive, di abetic, and elderly populations. Although different methods have been used for measuring and expressing urinary albumin excretion and a vari ety of cutoff levels have been used for defining microalbuminuria, pre valence of microalbuminuria appears to be higher in non-Europeans (8%- 28%) than in Europeans (2%-10%). However, because of the large within- individual variability of urinary albumin excretion and the relatively low prevalence of microalbuminuria, large studies are required to det ect statistically significant associations between albuminuria and car diovascular risk factors. Evidence presented here supports the proposi tion that microalbuminuria represents a marker of cardiovascular disea se risk in nondiabetic individuals as well as diabetic individuals. Mo reover, because of the high sensitivity of the test and because albumi nuria is a concomitant of many forms of renal disease, microalbuminuri a also has a role in detecting patients with renal involvement associa ted with essential hypertension, lupus erythematosus, women with pre-e clampsia, and subjects with unsuspected primary and secondary nephropa thies.