Proteinuria- Long Term Complications

Patients with diabetes or hypertension with microalbuminuria (MA)/ proteinuria are prone to CV risk and progressive renal damage. This risk increases progressively with increasing levels of proteinuria. MA generally increases the relative risk of CV mortality by 1.3 and macroproteinuria by 2.4. 10-20% of hypertensive, 30-40% of diabetics and 5-7% of healthy population has MA. The CV risk exists even in seemingly healthy population with MA (without diabetes or hypertension). A population based British study on ischemic stroke reported a hazard ratio of 1.48 in patients with MA and 2.46 for macroproteinuric patients. Data from population based studies from Korea, Japan and from UK shows that 10-12 % of population has MA and approx 1% have proteinuria. Reduction in proteinuria in all subgroups is associated with reduction in this risk. Hence MA or proteinuria provides an excellent early target for intervention.