MICROALB-CARDIO study: Screening for microalbuminuria in type 2 diabetic hypertensive patients by cardiologists in France

Objective: To determine the prevalence of microalbuminuria (MAU) detected by a specific urinary strip in type 2 diabetic hypertensive patients in metropolitan France. Method: Screening for MAU with a semi-quantitative strip measuring the albumin /creatinine ratio was performed by cardiologists (Cs) in 6 type 2 diabetic hypertensive patients. This screening method was considered reliable if a preliminary search for proteinuria was performed with a usual strip and the quality of the MAU reading was good. Results: 222 Cs screened 1,328 patients (65.3% M, average age 67 10 years, BMI 29.2 +/- 4.8 kg/m(2)). MAU screening was considered reliable for 1166 patients (90.8%): 58.1 % had MAU (alb/creat ratio between 30 and 300 mg/g), and 3.4% had manifest MAU (alb/creat ratio > 300 mg/g). The prevalence of MAU increased with the severity of hypertension. In the population with a reliable MAU screen, the analysis of risk factors according to the level of MAU yielded the following results: [GRAPHICS] In the MAU+ group, the need for multiple antidiabetic (including insulin) and antihypertensive drugs was more frequent. In contrast to current guidelines, 30% of patients did not received an antiplatelet agent, and about one fourth (24.1 %) of the patients did not benefit of a hypolipemic treatment. Conclusion: Screening for proteinuria in type 2 diabetic hypertensive patients is well performed by cardiologists. The prevalence of MAU is high in this patient population, which may be explained by their high global cardiovascular risk, illustrated by the prevalence of comorbidities and risk factors, significantly higher in the MAU+ group, with less frequent BP control despite a more aggressive antihypertensive treatment. Prescription of antiplatelet therapy and hypolipidemic agents must be optimised.