Microalbuminuria, renal disease, metabolic syndrome and risks in diabetes

Microalbuminuria was identified as an important predictor of renal disease as well as of cardiovascular disease about 20 years ago. This concept has been confirmed in many studies, and it has been shown that microalbuminuria is associated to the metabolic syndrome. Microalbuminuria is an important risk marker along with a series of other markers and factors. It is associated to a structural damage in the kidney, and a loss of auto-regulation and inflammation.It is a predictor of proteinuria, low GFR and cardiovascular events as well as of end-stage renal disease and mortality, including cardiovascular mortality.Microalbuminuria is an important goal for intervention. Several studies have shown that reduction of microalbuminuria indicates a better prognosis. The reason is not clear but may be associated to less structural damage in patients that show regression in microalbuminuria. It is recommended to screen for microalbuminuria in diabetic patients with hypertension and may be in the population, although this is less clarified.