Micro-albuminuria in non-diabetic acute ischaemic stroke: prevalence and its co-relation with stroke severity
DOI:
https://doi.org/10.18203/2320-6012.ijrms20170647Keywords:
Ischaemic stroke, Microalbuminuria, National Institutes of health stroke scaleAbstract
Background: Microalbuminuria is not only a predictor of subsequent kidney disease, but also an indicator of generalised endothelial injury and a manifestation of endothelial dysfunction. The present study is aimed to determine the prevalence of microalbuminuria among non–diabetic ischaemic stroke patients and find its correlation with ischaemic stroke which eventually will aid us in coming up with potent strategies to provide better prevention and cure.
Methods: The present study was conducted in Department of Medicine in collaboration with Department of Biochemistry and Department of Radiology, Guru Nanak Dev Hospital, Amritsar, Punjab, India after taking approval from institutional thesis and ethical committee. The study included 60 patients (30 Cases + 30 Controls) in age group 20-80 years diagnosed as stroke and haemorrhage ruled out by NCCT Brain/MRI Brain at admission. Cases were patients with history of hypertension with acute ischaemic stroke. Controls were age and sex matched patients with no history of hypertension with acute ischaemic stroke. The microalbuminuria was assayed by immunoturbimetry. The stroke severity was assessed by NIH Stroke Severity scale. P value less than 0.05 was considered the level of significance.
Results: The overall prevalence of microalbuminuria in acute ischaemic stroke patients was 41.67%. When comparing NIH SS (National Institutes of Health Stroke Scale) score with the levels of albumin in urine, there was a significant positive correlation with urinary albumin levels and stroke severity in the patients having urinary albumin levels in microalbuminuria range both in Case group and Control group with P value less than 0.05.
Conclusions: Urine albumin excretion had a positive correlation with the NIH SS Score of the patient in acute ischemic stroke. Those with a higher NIH SS Score had a higher rate of urine albumin excretion and vice versa. Therefore, measurement of microalbuminuria may help to assess those who are at increased risk of severe stroke and may require a more aggressive management.References
Bonita R, Beaglehole R. Stroke prevention in poor countries: time for action. Stroke. 2007;38(11):2871-2.
Pandian JD, Srikanth V, Read SJ, Thrift AG. Poverty and stroke in India: a time to act. Stroke. 2007;38(11):3063-9.
Seshadri S, Beiser A, Kelly-Hayes M, Kase CS, Au R, Kannel WB, et al. The lifetime risk of stroke: estimates from the Framingham Study. Stroke. 2006;37(2):345-50.
Parving HH, Osterby R, Ritz E, Brenner BM, Levine S, Saunders WB. Microalbuminuria in Diabetic nephropathy. The Kidney. Philadelphia. 2000;8:1731-73.
Gosling P. Microalbuminuria: a marker of systemic disease. Br J Hosp Med. 1995;54:285-7.
Maskey A, Parajuli M, Kohli SC. A study of risk factors of stroke in patients admitted in Manipal Teaching Hospital, Pokhara. Kathmandu Univ Med J KUMJ. 2011;9(36):244-7.
Vaidya C, Majmudar D. A retrospective study of clinical profile of stroke patients from GMERS Medical College and Hospital, Gandhinagar, Gujarat. Int J Clin Trials. 2014;62-6.
Awad SM, Al-Jumaily HF, Al-Dulaimi KM, Abdulghafoor RH. Assessment of major risk factors among stroke patients. Saudi Med J. 2010;31(9):1028-31.
Aiyar et al. A study of clinic-radiological correlation in cerebrovascular stroke (A study of 50 cases). Guj Med J. 1999;52:58-63.
Sabharwal RK, Singh P, Arora MM, Somani BL, Ambade V. Incidence of microalbuminuria in hypertensive patients. Indian J Clin Biochem. 2008;23(1):71-5.
Bigazzi R, Bianchi S, Campese VM, Baldari G. Prevalence of microalbuminuria in a large population of patients with mild to moderate essential hypertension. Nephron. 1992;61(1):94-7.
Romundstad S, Holmen J, Kvenild K, Hallan H, Ellekjaer H. Microalbuminuria and all-cause mortality in 2,089 apparently healthy individuals: a 4.4-year follow-up study. The Nord-Trøndelag Health Study (HUNT), Norway. Am J Kidney Dis Off J Natl Kidney Found. 2003;42(3):466-73.
Hillege HL, Wilbert MT, Bak JAAA, Giller IH, Grobber DDE, Harry JGM Crijns, et al. Microalbuminuria in non-diabetic non-hypertensive population. J Intern Med. 2001;249:519-26.
Mathur PC, Punckar P, Muralidharan R. Microalbuminuria In Nondiabetic Acute Ischaemic Stroke - An Indian Perspective. Ann Indian Acad Neurol. 2005;8(4):237.
Pavan M, Ranganath R, Chaudhari AP, Shetty M. Obesity as an Independent Risk Factor for the Development of Microalbuminuria. Nephro-Urol Mon. 2011;3(4):276-9.
Løkkegaard N, Haupter I, Kristensen TB. Microalbuminuria in obesity. Scand J Urol Nephrol. 1992;26(3):275-8.
Valensi P, Assayag M, Busby M, Pariès J, Lormeau B, Attali JR. Microalbuminuria in obese patients with or without hypertension. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 1996;20(6):574-9.
Ali A, Taj A, Amin MJ, Iqbal F, Iqbal Z. Correlation between Microalbuminuria and Hypertension in Type 2 Diabetic Patients. Pak J Med Sci. 2014;30(3):511-4.
Poudel B, Yadav BK, Nepal AK, Jha B, Raut KB. Prevalence and Association of Microalbuminuria in Essential Hypertensive Patients. North Am J Med Sci. 2012;4(8):331-5.
Toth P, Koller A, Pusch G, Bosnyak E, Szapary L, Komoly S, et al. Microalbuminuria, indicated by total versus immunoreactive urinary albumins, in acute ischemic stroke patients. J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2011;20(6):510-6.
Muralidhara N, Rajanna R, Varakanahalli S, Goyal V. Prevalence of microalbuminuria in patients with non-diabetic acute ischemic stroke. Int J Res Med Sci. 2015;3(4):954-7.