Background: The prevalence of end-stage renal disease (ESRD) is uprising in the paralleled with the increase of chronic kidney disease (CKD) patients. The objective of this study was to assess the value of macroalbuminuric of kidney disease in diabetic and/or hypertensive patients and the risk factors associated with microalbuminuric.
Methods: A total of 3986 patients diagnosed with diabetes and/or hypertension aged 40 years and over was investigated by randomized cluster sampling in the Zhengzhou community and 1453 participants were analyzed in this study. The clinical data were investigated, including the urinary albumin–to-creatinine ratio (ACR), total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, glycated hemoglobin of HbAlc, fasting plasma glucose, 2-h postprandial plasma, and serum creatinine. The ACR was applied to designate albuminuric. The prevalence of macroalbuminuric was calculated and the risk factors associated with macroalbuminuric were evaluated by stepwise logistic regression.
Results: These comprised 612 males and 841 females and the mean age of all patients was 60.6±9.3 years. The prevalence of microalbuminuric and macroalbuminuric was 12.0%, 1.6%, respectively. The prevalence of microalbuminuric in patients with diabetes, hypertension and both diabetes and hypertension were 8.4%, 9.7% and 17.6%, respectively. In subjects with both diabetes and hypertension, the prevalence of microalbuminuric, macroalbuminuric were significantly higher than those who had diabetes or hypertension only. Logistic regression analysis showed microalbuminuric to be significantly associated with systolic blood pressure (OR: 1.92; 95% CI: 1.36-2.72; P < 0.001), diastolic blood pressure (OR: 1.53; 95% CI: 1.02-2.28; P = 0.038), HbA1c (OR: 2.31; 95% CI: 1.64-3.26; P < 0.001). Fasting plasma glucose (OR: 1.79; 95% CI: 1.18-2.71; P = 0.006) and hypertension (OR: 2.45; 95% CI: 1.64-3.65; P < 0.001) were the main independent factors for microalbuminuric in diabetic patients with hypertension or not.
Conclusion: The prevalence of microalbuminuric observed in patients diagnosed with diabetes and/or hypertension aged over 40 reached up to 12.0% in the Zhengzhou community. Microalbuminuric was strongly associated with systolic blood pressure, diastolic blood pressure and HbA1c. Fasting plasma glucose and hypertension were the main independent factors for microalbuminuric in diabetic patients with hypertension or not.