Pathological Protein Loss and Hypertension

A high blood pressure often goes unnoticed or only manifests late as symptoms of diseases, while damage affecting various organs can be detected early on. The health of the inner layer of the vascular system is crucial, as improper functioning can lead to decreased elasticity of the blood vessels, which may result in the formation of calcified plaques and changes in the blood coagulation processes.

The condition of the kidney’s small vessels is indicated by the presence of albumin in the urine, which provides information about the amount of protein excretion. This examination is particularly important, as abnormal albumin levels can carry serious health risks.

During urine tests, the amount of albumin can be measured from the first morning sample or from a 24-hour collection. Considering the normal values makes it easier to identify patients whose kidney function may be developing abnormally. The relationship between high blood pressure and microalbuminuria is close, as the latter condition poses an increased risk for cardiovascular diseases.

What is microalbuminuria?

Microalbuminuria refers to the minimal amount of albumin excretion in the urine, indicating the presence of an abnormal quantity of protein. Standard urine tests typically only detect larger amounts of protein, so the diagnosis of microalbuminuria is based on specialized tests. If the urine contains 30-300 mg/day of albumin, this can be a warning sign and justifies the need for further examinations.

Microalbuminuria often occurs as a consequence of high blood pressure and indicates damage to the kidney’s glomeruli. These glomeruli function as filters, and when their normal operation is disrupted, the small vessels become more permeable, leading to the passage of proteins into the urine. Research shows that the appearance of microalbuminuria is closely linked to an increased risk of cardiovascular events, such as heart attacks or heart failure.

It is important to mention that microalbuminuria reflects not only the state of the kidneys but also the overall condition of the vascular system. Among patients suffering from high blood pressure, the prevalence of microalbuminuria can reach as high as 40%, which can lead to cardiovascular damage, such as thickening of the heart muscle or narrowing of the carotid arteries.

Why is the examination of microalbuminuria important?

The examination of microalbuminuria is crucial as it allows for the assessment of patients’ cardiovascular risk. The test can be performed through simple testing, and with properly managed blood pressure and medication, protein excretion can be significantly reduced. The use of angiotensin receptor blockers and ACE inhibitors, for example, can effectively help mitigate cardiovascular risks.

The amount of urine albumin depends on various factors, such as fever or physical activity. Therefore, a single positive sample result is not sufficient for diagnosis. For the most accurate data, a 24-hour urine collection is recommended, which allows for the precise determination of the albumin amount.

As an alternative, the albumin-to-creatinine ratio can be measured in randomly collected samples. Since creatinine excretion is generally constant, this ratio can serve as a more reliable correction factor, taking into account the daily variations in urine concentration.

How is the examination of microalbuminuria conducted?

The examination of microalbuminuria can be performed using various methods, with the most common procedure being the analysis of urine samples. To achieve the most accurate results, a 24-hour urine collection is recommended, during which the patient must collect the total urine volume. This method requires greater cooperation from the patient but allows for a more accurate diagnosis.

As an alternative, determining the albumin-to-creatinine ratio from random samples is also common. The advantage of this method is that it is quicker and less burdensome for the patient; however, it must be considered that urine concentration varies throughout the day. Thus, examining the albumin and creatinine ratio can provide a more reliable picture of the kidney’s condition and potential risks.

Overall, the examination of microalbuminuria is an essential part of the care for patients living with high blood pressure, as it can help identify the risk of respiratory diseases in a timely manner and allows for the selection of appropriate treatment options.