Albuminuria Predicts Kidney Function Outcome in Egyptian Essential Hypertensive Patients

Background and Aims: Hypertension is both a cause and effect of renal impairment and its treatment influences kidney function outcome, interests in the study of albuminuria in hypertensive patients has grown as it may represent a useful and relatively inexpensive clinical tool for the identification of hypertensive patients at higher risk for developing early renal impairment. In Egypt, hypertension is one of the most important causes of end stage renal disease (ESRD). The aim of the work is to identify albuminuria in Egyptian essential hypertensive patients, and its relation with kidney function outcome. Methods: Two hundred and forty one essential hypertensive patients, were included in a cross-section study for the presence of albuminuria and its relation to estimated glomerular filtration rate (eGFR); their history of hypertension ranges from 12-240 months with a mean of 75±54 (aged 48±11 years, range 20 – 76 years) any patient with doubtful history of essential hypertension were excluded from the study, patients included in the study were 148 (61%) males and 93 females, their mean body mass index was 27±5 kg/m2. Results: Prevalence of normoalbuminuria was 59%, microalbuminuria 31%, and macroalbuminuria 10%. eGFR was significantly decreased in microalbuminuria and macroalbuminuria groups, on further analysis this reduction in eGFR was not related to severity of hypertension but to its duration. There was a significant increase in the duration of history hypertension in eGFR < 60 ml/min/1.73 m2 in comparison to eGFR > 60 ml/min/1.73 m2 in all groups (Normo, Micro and Macroalbumiuria). There was no significant difference eGFR between controlled and uncontrolled groups (either by MDRD or Mayo clinic formula). Conclusions: Albuminuria is a risk marker for prediction of the progression of nephropathy in Egyptian essential hypertensive patients and may reflect hypertensive injury to the kidney.