Información del artículo
La microalbuminuria como hallazgo clínico, se considera un marcador del daño orgánico renal en el paciente diabético. Además, su tratamiento en este tipo de pacientes ha demostrado una disminución en la progresión de la nefropatía diabética. En el presente trabajo, se realiza una revisión bibliográfica para intentar resolver hasta que punto se considera a la microalbuminuria un factor de riesgo cardiovascular, si sería correcto hacer determinaciones a la población general y si un tratamiento posterior mejoraría bien el riesgo cardiovascular o bien el pronóstico de los que presenten ya en algún grado la enfermedad cardiovascular.
Palbras clave:
microalbuminuria
factor
cardiovascular
Microalbuminuria as a clinical finding is considered a marker of renal organic injury in the diabetic patient. In addition, its treatment in this type of patients has demonstrated a decrease in the progression of diabetic nephropathy. In the present study, a bibliographic review is performed to try to resolve up to what point microalbuminuria is considered a cardiovascular risk factor, if it would be correct to make determinations in the general population and if a posterior treatment would well improve the cardiovascular risk or the prognosis of those who already present cardiovascular disease in some grade.
Key words:
microalbuminuria
factor
cardiovascular
El Texto completo está disponible en PDF
Bibliografía
[1.]
C.E. Mogensen, E. Vestbo, P.L. Poulsen, C. Christiansen, E.M. Damsgaard, H. Eiskjaer, et al.
Microalbuminuria and potential confounders. A review and some observations on variability of urinary albumin excretion.
Diabetes Care, 18 (1995), pp. 572-581
[2.]
Y. Nakamura, B.D. Myers.
Charge selectivity of proteinuria in diabetic glomerulopathy.
Diabetes, 37 (1988), pp. 1202-1211
[3.]
P. Fioretto, M.W. Steffes, S.M. Mauer.
Glomerular structure in nonproteinuric IDDM patients with various levels of albuminuria.
Diabetes, 43 (1994), pp. 1358-1364
[4.]
J. Abellán, F. Hernández, J.A. García-Galbis, J.B. Gómez, J. Madrid, A. Martinez, et al.
Los nuevos factores de riesgo cardiovascular.
Hipertensión, 4 (2001), pp. 171-185
[5.]
M. Roest, J.D. Banga, W.M.T. Janssen, D.E. Grobbee, J.J. Sixma, P.E. de Jong, et al.
Excessive urinary albumin levels are associated with future cardiovascular mortality in postmenopausal women.
Circulation, 103 (2001), pp. 3057-3061
[6.]
H.C. Gerstein, J.F. Mann, Q. Yi, B. Zinman, S.F. Dinneen, B. Hoogwerf, et al.
Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals.
JAMA, 286 (2001), pp. 421-426
[7.]
J. Bonet, J. Vila, M.J. Alsina, L. Ancochea, R. Romero.
Prevalencia de microalbuminuria en la población general de un área mediterránea española y su asociación con otros factores de riesgo cardiovascular.
Med Clin (Barc), 116 (2001), pp. 573-574
[8.]
W.F. Terpstra, J.F. May, A.J. Smit, P.A. de Graeff, H.J. Crijns.
Microalbuminuria is related to marked end organ damage in previously untreated, elderly hypertensive patients.
Blood Press, 11 (2002), pp. 84-90
[9.]
G.F. Diercks, A.J. van Boven, H.L. Hillege, W.M. Jansen, J.A. Kors, P.E. de Jong, et al.
Microalbuminuria is independently associated with ischaemic electrocardiographic abnormalities in a large non-diabetic population. The PREVEND (Prevention of Renal and Vascular Endstage Disease) study.
Eur Heart J, 21 (2002), pp. 1922-1927
[10.]
F.C. Luft, B. Agrawal.
Microalbuminuria as a predictive factor for cardiovascular events.
J Cardiovasc Pharmacol, 33 (1999), pp. 11-15
[11.]
L.M. Ruilope.
Prevalence of renal disease in elderly hypertensive patients with cardiovascular problems.
Coron Artery Dis, 8 (1997), pp. 483-488
[12.]
B. Agrawal, A. Berger, K. Wolf, F.C. Luft.
Microalbuminuria screening by reagent strip predicts cardiovascular risk in hypertension.
J Hypertens, 14 (1996), pp. 223-228
[13.]
E.K. Hoogeveen, P.J. Kostense, A. Jager, R.J. Heine, C. Jakobs, L.M. Bouter, et al.
Serum Homocysteine level and protein intake are related to risk of microalbuminuria: The Hoorm Study.
Kidney Int, 54 (1998), pp. 203-209
[14.]
T.B. Monster, W.M. Janssen, P.E. de Jong, L.T. de Jong-van den Berg.
Oral contraceptive use and hormone replacement therapy are associated with microalbuminuria.
Arch Intern Med, 161 (2001), pp. 2000-2005
[15.]
M. Ravid, R. Lang, R. Rachmani, M. Lishner.
Long-Term renoprotective effect of angiotensin-converting enzyme inhibition in non-insulin dependent diabetes mellitus.
Arch Intern Med, 156 (1996), pp. 286-289
[16.]
M. Ravid, D. Brosh, Z. Levi, Y. Bar-Dayan, D. Ravid, R. Rachamani.
Use of enalapril to attenuate decline in renal function in normotensive, normoalbuminuric patients with type 2 diabetes mellitus. A randomized, controlled trial.
Ann Intern Med, 128 (1998), pp. 982-988
[17.]
H.E. Lebovitz, T.B. Wiegmann, A. Cnaan, S. Shahinfar, D.A. Sica, V. Broadstone, et al.
Renal protective effects of enalapril in hypertensive NIDDM: role of baseline albuminuria.
Kidney Int Suppl, 45 (1994), pp. S150-S155
[18.]
H.H. Parving, H. Lehnert, J. Brochner-Mortensen, R. Gomis, S. Andersen, P. Arner.
The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes.
N Engl J Med, 345 (2001), pp. 870-878
[19.]
C.E. Mogensen, S. Neldam, I. Tikkanen, S. Oren, R. Viskoper, R.W. Watts, et al.
Randomized controlled trial of dual blockade of reninangiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: The candesartan an lisinopril microalbuminuria (CALM) study.
BMJ, 321 (2000), pp. 1440-1444
[20.]
J.P. Garg, G.L. Bakris.
Microalbuminuia: marker of vascular dysfunction, risk factor for cardiovascular disease.
Vasc Med, 7 (2002), pp. 35-43
[21.]
M. Moser.
Current recomendations for the treatment of hypertension: are they still valid?.
J Hypertens, 20 (2002), pp. S3-S10
[22.]
P. Sleight.
The HOPE study (Heart Outcomes Prevention Evaluation).
J Renin Angiotensin Aldosterone Syst, 1 (2000), pp. 18-20
[24.]
J. Redon.
Renal protection by antihypertensive drugs: insights from microalbuminuria studies.
J Hypertens, 16 (1998), pp. 2091-2100
[25.]
Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes:UKPDS 39. UK Prospective Diabetes Study Group..
BMJ, 317 (1998), pp. 713-720
[26.]
H.L. Hillege, W.N. Janssen, A.A. Bak, G.F. Diercks, D.E. Grobbee, H.J. Crijns, et al.
Microalbuminuria is common, also in nondiabetic, nohipertensive population, and an independent indicator of cardiovascular risk factor and cardiovascular morbidity.
J Intern Med, 249 (2001), pp. 519-526
[27.]
G.L. Bakris.
Microalbuminuria: what is it? why is it important? what should be done about it?.
J Clin Hipertens (Greenwich), 3 (2001), pp. 99-102
Copyright © 2004. Elsevier España, S.L. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN)
