The Clinical Applicability of Albuminuria Testing in Japanese Hypertensive Patients: The AVA-E Study
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概要
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Objective Albuminuria is thought to reflect generalized endothelial dysfunction. In hypertensive patients, albuminuria increases the risk of cardiovascular disease (CVD) events. Therefore, screening for albuminuria is critical for stratifying risks in hypertensive patients. However, a limited number of Japanese studies have performed quantitative examinations of albuminuria. The objective of this study was to examine the utility of the CLINITEK MICROALB CREATININE TEST for albuminuria screening. Materials The CLINITEK MICROALB CREATININE TEST consists of a urine test strip that assesses albumin excretion corrected for the urine creatinine levels in only 60 seconds without the need for any special facilities. The CLINITEK MICROALB CREATININE TEST was performed in 5,647 Japanese hypertensive patients, excluding diabetic patients, and the clinical significance of the test was evaluated. Results According to the CLINITEK MICROALB CREATININE TEST, the A1 (albumin creatinine ratio: ACR <30 mg/g･creatinine), A2 (ACR 30-299 mg/g･creatinine) and A3 (ACR ≥300 mg/g･creatinine) levels of albuminuria were present in 61.2%, 32.5% and 6.3% of the patients surveyed, respectively. The proportions of A2 and A3 patients increased with chronic kidney disease (CKD) stage, blood pressure, age and previous history of CVD. According to a multivariate logistic regression analysis, the A2 and A3 levels of albuminuria were found to be independently associated with a previous history of CVD (odds ratio: 1.36, 95% confidence interval: 1.08-1.72, p<0.01) after adjusting for age, diabetes, blood pressure and estimated glomerular filtration rate (eGFR). Conclusion In hypertensive patients, the A2 and A3 levels of albuminuria on the CLINITEK MICROALB CREATININE TEST are associated with a previous history of CVD, independent of eGFR. Therefore, by reflecting the status of systemic vascular injury, this test may help to perform CVD risk stratification.
著者
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Tani Yoshihiro
Department Of Physics Tokyo Institute Of Technology
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Nakayama Masaaki
Department Of Applied Physics Faculty Of Engineering Osaka City University
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Hayashi Yoshimitsu
Department Of Internal Medicine Nagoya Kosein Hospital
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Kanno Makoto
Department Of Ophthalmology And Visual Sciences Yamagata University School Of Medicine
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Asahi Koichi
Department Of Internal Medicine Iii Fukushima Medical University School Of Medicine
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Watanabe Kimio
Department Of Mathematics University Of Tsukuba
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Tanaka Kenichi
Department Of Anesthesiology Emory University School Of Medicine
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Kimura Hiroshi
Department Of Anatomy Ii Shiga University Of Medical Science
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Watanabe Tsuyoshi
Department Of Anatomy Asahikawa Medical University
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ISEKI Kunitoshi
Dialysis Unit
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Iseki Kunitoshi
Dialysis Unit, University Hospital of the Ryukyus, Japan
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TANI YOSHIHIRO
Department of Internal Medicine, Division of Nephrology, Hypertension, Endocrinology, and Diabetology/Metabolism, Fukushima Medical University School of Medicine
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Tani Yoshihiro
Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Japan
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