Document Detail


Cystatin C as predictor of microalbuminuria in the early stage of hypertension.
MedLine Citation:
PMID:  19729966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Predictors of microalbuminuria in the early stage of hypertension are not well known. We did a prospective study to investigate whether glomerular hyperfiltration assessed from serum cystatin C predicts development of microalbuminuria in hypertension. METHODS: We assessed 101 treatment-naive subjects screened for stage 1 hypertension and followed-up for a median 3.1 years. Cystatin C was measured at entry and glomerular filtration rate was estimated using the Hoek formula (CystGFR). Urinary albumin and ambulatory blood pressure were measured at entry and during the follow-up. RESULTS: Subjects in the top CystGFR tertile (>115 ml/min/1.73 m(2)) were leaner (p = 0.002) and developed microalbuminuria more frequently (p = 0.02) than the rest of the group. In univariate Cox regression, CystGFR was associated with future microalbuminuria (hazard ratio, 1.06, 95% confidence interval (CI), 1.02-1.10, p = 0.001). After controlling for baseline albumin excretion rate and several confounders, CystGFR remained a significant predictor of microalbuminuria development (hazard ratio, 1.19, 95% CI, 1.03-1.37, p = 0.019). The association between future microalbuminuria and creatinine clearance or glomerular filtration rate estimated with the Cockroft-Gault or the Modification of Diet in Renal Disease formula did not attain the level of statistical significance in this sample. CONCLUSIONS: The present findings indicate that CystGFR is more sensitive than creatinine clearance or estimated glomerular filtration rate for predicting microalbuminuria development in the early stage of hypertension and confirm that hyperfiltration precedes microalbuminuria in this clinical entity.
Authors:
Paolo Palatini; Elisabetta Benetti; Ada Zanier; Massimo Santonastaso; Adriano Mazzer; Susanna Cozzio; Giuseppe Zanata; Renzo De Toni; Martina Zaninotto
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-09-03
Journal Detail:
Title:  Nephron. Clinical practice     Volume:  113     ISSN:  1660-2110     ISO Abbreviation:  Nephron Clin Pract     Publication Date:  2009  
Date Detail:
Created Date:  2009-11-26     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101159763     Medline TA:  Nephron Clin Pract     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  c309-14     Citation Subset:  IM    
Copyright Information:
(c) 2009 S. Karger AG, Basel.
Affiliation:
Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy. palatini@unipd.it
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MeSH Terms
Descriptor/Qualifier:
Albuminuria / blood,  diagnosis*,  epidemiology*
Biological Markers / blood
Comorbidity
Cystatin C / blood*
Female
Humans
Hypertension / blood,  diagnosis*,  epidemiology*
Incidence
Italy / epidemiology
Male
Proportional Hazards Models*
Reproducibility of Results
Risk Assessment / methods
Risk Factors
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cystatin C

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