Accuracy of retinal changes in predicting microalbuminuria among elderly hypertensive patients: a cross-sectional study from a teaching hospital in South India
Objective Microalbuminuria is an important marker of end organ damage in hypertensive patients, but is often not tested for, especially in a resource-poor setting. We studied the accuracy of retinal changes in predicting microalbuminuria among a cohort of geriatric hypertensive patients. Methods One...
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| Veröffentlicht in: | International urology and nephrology 2009, Vol.41 (1), p.137-143 |
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| creator | Shantha, Ghanshyam Palamaner Subash Bhaskar, Emmanuel Kumar, Anita A. Sundaram, Varun Senghor, Arul Swaminathan, Porchelvan Sundaresan, Manjunath Srinivasan, Yadav Abraham, Georgi |
| description | Objective
Microalbuminuria is an important marker of end organ damage in hypertensive patients, but is often not tested for, especially in a resource-poor setting. We studied the accuracy of retinal changes in predicting microalbuminuria among a cohort of geriatric hypertensive patients.
Methods
One hundred and eighty elderly hypertensive patients aged more than 65 years were assessed for their demographic characteristics, smoking status, duration of hypertension, current severity of hypertension, body mass index, left ventricular hypertrophy by electrocardiogram (ECG), and high sensitivity C-reactive protein (HsCRP). Optic fundi were assessed for retinopathy after pupillary dilatation, and were photographed. Microalbuminuria (albumin–creatinine ratio) was measured as an average of two nonconsecutive overnight spot urine samples. Patients with pre-diabetes, diabetes, metabolic syndrome, treatment with angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, overt nephropathy or proteinuria, and active infection were excluded.
Results
Mean age was 74 ± 6.56 years. One-third were obese and 18.9% had left ventricular hypertrophy. Prevalence of microalbuminuria was 39.4% and prevalence of retinopathy was 40%. Microalbuminuria showed a strong association with retinopathy (
P
|
| doi_str_mv | 10.1007/s11255-008-9452-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_66935597</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>66935597</sourcerecordid><originalsourceid>FETCH-LOGICAL-c369t-5f3a5ab3532f20fdaaf31626bda67642fce10c22b2e793b1b27082c032c374263</originalsourceid><addsrcrecordid>eNp1kc1q3TAQhUVpaG7TPkA3RXTRnRr9WLLdXQj9CQS6SLoWsjyKFWzLleSAn6avWrn3QqDQlWDmzJk5-hB6x-gnRml9mRjjUhJKG9JWkhP1Ah2YrAXhsqleogMVlBGmuDhHr1N6pJS2DaWv0DlraqUq2R7Q7ytr12jshoPDEbKfzYjtYOYHSNjPeInQe1vKD3jyNgYzduvk5zV6g80UShnGHuK44WFbIGaYk38CvJjsYc7pMza4TKVEEhSXsLunvPYbdjFMpZnB2GF3H0JafC7tsvQurHnAN3PvzRt05syY4O3pvUA_v365v_5Obn98u7m-uiVWqDYT6YSRphNScMep641xogRXXW9UrSruLDBqOe841K3oWMdr2nBLBbeirrgSF-jj0XeJ4dcKKevJJwvjaGYIa9JKtULKti7CD_8IH8MaS66kOVPlYwVvi4gdRX-zR3B6iX4ycdOM6h2dPqLTBZ3e0en9gvcn47WboH-eOLEqAn4UpNIqfOLz5v-7_gF8WKcg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>216187329</pqid></control><display><type>article</type><title>Accuracy of retinal changes in predicting microalbuminuria among elderly hypertensive patients: a cross-sectional study from a teaching hospital in South India</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Shantha, Ghanshyam Palamaner Subash ; Bhaskar, Emmanuel ; Kumar, Anita A. ; Sundaram, Varun ; Senghor, Arul ; Swaminathan, Porchelvan ; Sundaresan, Manjunath ; Srinivasan, Yadav ; Abraham, Georgi</creator><creatorcontrib>Shantha, Ghanshyam Palamaner Subash ; Bhaskar, Emmanuel ; Kumar, Anita A. ; Sundaram, Varun ; Senghor, Arul ; Swaminathan, Porchelvan ; Sundaresan, Manjunath ; Srinivasan, Yadav ; Abraham, Georgi</creatorcontrib><description>Objective
Microalbuminuria is an important marker of end organ damage in hypertensive patients, but is often not tested for, especially in a resource-poor setting. We studied the accuracy of retinal changes in predicting microalbuminuria among a cohort of geriatric hypertensive patients.
Methods
One hundred and eighty elderly hypertensive patients aged more than 65 years were assessed for their demographic characteristics, smoking status, duration of hypertension, current severity of hypertension, body mass index, left ventricular hypertrophy by electrocardiogram (ECG), and high sensitivity C-reactive protein (HsCRP). Optic fundi were assessed for retinopathy after pupillary dilatation, and were photographed. Microalbuminuria (albumin–creatinine ratio) was measured as an average of two nonconsecutive overnight spot urine samples. Patients with pre-diabetes, diabetes, metabolic syndrome, treatment with angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, overt nephropathy or proteinuria, and active infection were excluded.
Results
Mean age was 74 ± 6.56 years. One-third were obese and 18.9% had left ventricular hypertrophy. Prevalence of microalbuminuria was 39.4% and prevalence of retinopathy was 40%. Microalbuminuria showed a strong association with retinopathy (
P
< 0.0001). Logistic regression identified association of microalbuminuria with duration of hypertension (
P
= 0.001) and elevated high sensitivity C-reactive protein (
P
= 0.021). Retinopathy was associated with duration of hypertension (
P
= 0.001) and smoking (
P
< 0.0001). Tests of accuracy for retinopathy as a predictor of microalbuminuria showed a sensitivity of 72% and specificity of 81%.
Conclusion
Prevalence of microalbuminuria and retinopathy were quite high in our cohort of elderly hypertensive patients. Retinal changes of any grade probably have moderate accuracy in predicting microalbuminuria and hence we can initiate work-up for target organ damage, especially in a resource-poor setting.</description><identifier>ISSN: 0301-1623</identifier><identifier>EISSN: 1573-2584</identifier><identifier>DOI: 10.1007/s11255-008-9452-6</identifier><identifier>PMID: 18766459</identifier><identifier>CODEN: IURNAE</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Aged ; Aged, 80 and over ; Albuminuria - diagnosis ; Albuminuria - etiology ; Cross-Sectional Studies ; Female ; Hospitals, Teaching ; Humans ; Hypertension - complications ; India ; Male ; Medicine ; Medicine & Public Health ; Nephrology ; Nephrology - Original Paper ; Predictive Value of Tests ; Retinal Diseases - diagnosis ; Retinal Diseases - etiology ; Urology</subject><ispartof>International urology and nephrology, 2009, Vol.41 (1), p.137-143</ispartof><rights>Springer Science+Business Media, B.V. 2008</rights><rights>Springer Science+Business Media, B.V. 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c369t-5f3a5ab3532f20fdaaf31626bda67642fce10c22b2e793b1b27082c032c374263</citedby><cites>FETCH-LOGICAL-c369t-5f3a5ab3532f20fdaaf31626bda67642fce10c22b2e793b1b27082c032c374263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11255-008-9452-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11255-008-9452-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27911,27912,41475,42544,51306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18766459$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shantha, Ghanshyam Palamaner Subash</creatorcontrib><creatorcontrib>Bhaskar, Emmanuel</creatorcontrib><creatorcontrib>Kumar, Anita A.</creatorcontrib><creatorcontrib>Sundaram, Varun</creatorcontrib><creatorcontrib>Senghor, Arul</creatorcontrib><creatorcontrib>Swaminathan, Porchelvan</creatorcontrib><creatorcontrib>Sundaresan, Manjunath</creatorcontrib><creatorcontrib>Srinivasan, Yadav</creatorcontrib><creatorcontrib>Abraham, Georgi</creatorcontrib><title>Accuracy of retinal changes in predicting microalbuminuria among elderly hypertensive patients: a cross-sectional study from a teaching hospital in South India</title><title>International urology and nephrology</title><addtitle>Int Urol Nephrol</addtitle><addtitle>Int Urol Nephrol</addtitle><description>Objective
Microalbuminuria is an important marker of end organ damage in hypertensive patients, but is often not tested for, especially in a resource-poor setting. We studied the accuracy of retinal changes in predicting microalbuminuria among a cohort of geriatric hypertensive patients.
Methods
One hundred and eighty elderly hypertensive patients aged more than 65 years were assessed for their demographic characteristics, smoking status, duration of hypertension, current severity of hypertension, body mass index, left ventricular hypertrophy by electrocardiogram (ECG), and high sensitivity C-reactive protein (HsCRP). Optic fundi were assessed for retinopathy after pupillary dilatation, and were photographed. Microalbuminuria (albumin–creatinine ratio) was measured as an average of two nonconsecutive overnight spot urine samples. Patients with pre-diabetes, diabetes, metabolic syndrome, treatment with angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, overt nephropathy or proteinuria, and active infection were excluded.
Results
Mean age was 74 ± 6.56 years. One-third were obese and 18.9% had left ventricular hypertrophy. Prevalence of microalbuminuria was 39.4% and prevalence of retinopathy was 40%. Microalbuminuria showed a strong association with retinopathy (
P
< 0.0001). Logistic regression identified association of microalbuminuria with duration of hypertension (
P
= 0.001) and elevated high sensitivity C-reactive protein (
P
= 0.021). Retinopathy was associated with duration of hypertension (
P
= 0.001) and smoking (
P
< 0.0001). Tests of accuracy for retinopathy as a predictor of microalbuminuria showed a sensitivity of 72% and specificity of 81%.
Conclusion
Prevalence of microalbuminuria and retinopathy were quite high in our cohort of elderly hypertensive patients. Retinal changes of any grade probably have moderate accuracy in predicting microalbuminuria and hence we can initiate work-up for target organ damage, especially in a resource-poor setting.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Albuminuria - diagnosis</subject><subject>Albuminuria - etiology</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Hospitals, Teaching</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>India</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>Nephrology - Original Paper</subject><subject>Predictive Value of Tests</subject><subject>Retinal Diseases - diagnosis</subject><subject>Retinal Diseases - etiology</subject><subject>Urology</subject><issn>0301-1623</issn><issn>1573-2584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc1q3TAQhUVpaG7TPkA3RXTRnRr9WLLdXQj9CQS6SLoWsjyKFWzLleSAn6avWrn3QqDQlWDmzJk5-hB6x-gnRml9mRjjUhJKG9JWkhP1Ah2YrAXhsqleogMVlBGmuDhHr1N6pJS2DaWv0DlraqUq2R7Q7ytr12jshoPDEbKfzYjtYOYHSNjPeInQe1vKD3jyNgYzduvk5zV6g80UShnGHuK44WFbIGaYk38CvJjsYc7pMza4TKVEEhSXsLunvPYbdjFMpZnB2GF3H0JafC7tsvQurHnAN3PvzRt05syY4O3pvUA_v365v_5Obn98u7m-uiVWqDYT6YSRphNScMep641xogRXXW9UrSruLDBqOe841K3oWMdr2nBLBbeirrgSF-jj0XeJ4dcKKevJJwvjaGYIa9JKtULKti7CD_8IH8MaS66kOVPlYwVvi4gdRX-zR3B6iX4ycdOM6h2dPqLTBZ3e0en9gvcn47WboH-eOLEqAn4UpNIqfOLz5v-7_gF8WKcg</recordid><startdate>2009</startdate><enddate>2009</enddate><creator>Shantha, Ghanshyam Palamaner Subash</creator><creator>Bhaskar, Emmanuel</creator><creator>Kumar, Anita A.</creator><creator>Sundaram, Varun</creator><creator>Senghor, Arul</creator><creator>Swaminathan, Porchelvan</creator><creator>Sundaresan, Manjunath</creator><creator>Srinivasan, Yadav</creator><creator>Abraham, Georgi</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>2009</creationdate><title>Accuracy of retinal changes in predicting microalbuminuria among elderly hypertensive patients: a cross-sectional study from a teaching hospital in South India</title><author>Shantha, Ghanshyam Palamaner Subash ; Bhaskar, Emmanuel ; Kumar, Anita A. ; Sundaram, Varun ; Senghor, Arul ; Swaminathan, Porchelvan ; Sundaresan, Manjunath ; Srinivasan, Yadav ; Abraham, Georgi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c369t-5f3a5ab3532f20fdaaf31626bda67642fce10c22b2e793b1b27082c032c374263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Albuminuria - diagnosis</topic><topic>Albuminuria - etiology</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Hospitals, Teaching</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>India</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Nephrology - Original Paper</topic><topic>Predictive Value of Tests</topic><topic>Retinal Diseases - diagnosis</topic><topic>Retinal Diseases - etiology</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shantha, Ghanshyam Palamaner Subash</creatorcontrib><creatorcontrib>Bhaskar, Emmanuel</creatorcontrib><creatorcontrib>Kumar, Anita A.</creatorcontrib><creatorcontrib>Sundaram, Varun</creatorcontrib><creatorcontrib>Senghor, Arul</creatorcontrib><creatorcontrib>Swaminathan, Porchelvan</creatorcontrib><creatorcontrib>Sundaresan, Manjunath</creatorcontrib><creatorcontrib>Srinivasan, Yadav</creatorcontrib><creatorcontrib>Abraham, Georgi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International urology and nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shantha, Ghanshyam Palamaner Subash</au><au>Bhaskar, Emmanuel</au><au>Kumar, Anita A.</au><au>Sundaram, Varun</au><au>Senghor, Arul</au><au>Swaminathan, Porchelvan</au><au>Sundaresan, Manjunath</au><au>Srinivasan, Yadav</au><au>Abraham, Georgi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuracy of retinal changes in predicting microalbuminuria among elderly hypertensive patients: a cross-sectional study from a teaching hospital in South India</atitle><jtitle>International urology and nephrology</jtitle><stitle>Int Urol Nephrol</stitle><addtitle>Int Urol Nephrol</addtitle><date>2009</date><risdate>2009</risdate><volume>41</volume><issue>1</issue><spage>137</spage><epage>143</epage><pages>137-143</pages><issn>0301-1623</issn><eissn>1573-2584</eissn><coden>IURNAE</coden><abstract>Objective
Microalbuminuria is an important marker of end organ damage in hypertensive patients, but is often not tested for, especially in a resource-poor setting. We studied the accuracy of retinal changes in predicting microalbuminuria among a cohort of geriatric hypertensive patients.
Methods
One hundred and eighty elderly hypertensive patients aged more than 65 years were assessed for their demographic characteristics, smoking status, duration of hypertension, current severity of hypertension, body mass index, left ventricular hypertrophy by electrocardiogram (ECG), and high sensitivity C-reactive protein (HsCRP). Optic fundi were assessed for retinopathy after pupillary dilatation, and were photographed. Microalbuminuria (albumin–creatinine ratio) was measured as an average of two nonconsecutive overnight spot urine samples. Patients with pre-diabetes, diabetes, metabolic syndrome, treatment with angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, overt nephropathy or proteinuria, and active infection were excluded.
Results
Mean age was 74 ± 6.56 years. One-third were obese and 18.9% had left ventricular hypertrophy. Prevalence of microalbuminuria was 39.4% and prevalence of retinopathy was 40%. Microalbuminuria showed a strong association with retinopathy (
P
< 0.0001). Logistic regression identified association of microalbuminuria with duration of hypertension (
P
= 0.001) and elevated high sensitivity C-reactive protein (
P
= 0.021). Retinopathy was associated with duration of hypertension (
P
= 0.001) and smoking (
P
< 0.0001). Tests of accuracy for retinopathy as a predictor of microalbuminuria showed a sensitivity of 72% and specificity of 81%.
Conclusion
Prevalence of microalbuminuria and retinopathy were quite high in our cohort of elderly hypertensive patients. Retinal changes of any grade probably have moderate accuracy in predicting microalbuminuria and hence we can initiate work-up for target organ damage, especially in a resource-poor setting.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>18766459</pmid><doi>10.1007/s11255-008-9452-6</doi><tpages>7</tpages></addata></record> |
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| ispartof | International urology and nephrology, 2009, Vol.41 (1), p.137-143 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Aged, 80 and over Albuminuria - diagnosis Albuminuria - etiology Cross-Sectional Studies Female Hospitals, Teaching Humans Hypertension - complications India Male Medicine Medicine & Public Health Nephrology Nephrology - Original Paper Predictive Value of Tests Retinal Diseases - diagnosis Retinal Diseases - etiology Urology |
| title | Accuracy of retinal changes in predicting microalbuminuria among elderly hypertensive patients: a cross-sectional study from a teaching hospital in South India |
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