INTENSIVE TREATMENT OF PERSISTENT MICROALBUMINURIA: DETERMINANTS OF TREATMENT RESISTANCE
en el Central European Journal of Medicine.Este es el resumen:
Aims. Persistent microalbuminuria after treatment is a common finding. This
study tried to evaluate the causes of treatment resistance.
Patients and methods. Sample: 204 patients treated with renina-angiotensin-axis
(RAA) blocking drugs that showed positive microalbuminuria. Treatment was
increased during three months to reach a BP < 130/80 mmHg and to obtain
maximal RAA blockade. Then patient were classified as normoalbuminuric after
treatment (N group) and microalbuminuric in spite of treatment (M).
Results. Mean microalbuminuria at
recruitment was 48.5±25.6 mg/24h in N group and 90.0±140.3 mg/24h in M
group. It was reduced to 16.1±10.0 mg/day in N group and to 83.5±138.2 mg/day in M group.
At start, mean SBP and mean DBP were not different between groups. After treatment
SBP and DBP pressure were reduced in both groups (differences between groups
were not significant). Combined control of BP showed a slight increase in the
two groups but it have only statistical significance in the N group (p = 0.031,
McNemar test).
Conclusions: Persistent microalbuminuria seems to be
associated to poor blood pressure control. Effective blood pressure reduction was
followed by urinary albumin excretion decrease. Baseline severity of
microalbuminuria was the only clear predictor of remission after treatment.
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