MICROALBUMINURIA AND PREVENTION OF RENAL-INSUFFICIENCY AND CARDIOVASCULAR-DISEASES

Microalbuminuria, a slightly elevated urinary albumin excretion, predi cts renal failure in insulin-dependent diabetic patients and premature cardiovascular mortality in non-insulin-dependent diabetic patients a nd in the general population. It can be related to all currently estab lished cardiovascular risk factors. Regarding the relationship between urinary albumin and blood pressure, microalbuminuria seems to be an e arly indicator of renal disease, causing high blood pressure in some i nstances, whereas it looks like the consequences of renal damage produ ced by severe hypertension in other instances. To establish whether mi croalbuminuria is an integrated risk marker for renal and cardiovascul ar events, or truly a risk factor, and to validate the usefulness of s ome peculiar treatment strategies, clinical trials are required, takin g microalbuminuria as a selection criteria, and renal and cardiovascul ar events as endpoints. Am J Hypertens 1998;11:884-886 (C) 1998 Americ an Journal of Hypertension, Ltd.