Proteinuria Is a Marker of Uncontrolled Hypertension

Austin, Texas—Proteinuria is a marker for cardiovascular disease. Identification of patients with proteinuria allows for early treatment to decrease the cardiovascular risk. Michael P. Carson, MD, and colleagues conducted a retrospective chart review designed to identify hospitalized patients with proteinuria, examine the prevalence of concurrent use of medications known to decrease the level of proteinuria, and determine the number of patients placed on anti-proteinuric medications. Results of the analysis were reported during a poster session at the NKF 2018 Spring Clinical Meetings in a poster titled Prevalence of Proteinuria in Hospitalized Patients: A Marker of Uncontrolled Hypertension.

The analysis cohort included patients admitted to the Jersey Shore University Medical Center, Neptune, New Jersey, during the period 2010-2015. Available data included demographics, medical history, and laboratory values, including urinalysis. The researchers also identified appropriate medications, including antihypertensives known to mitigate proteinuria.

A total of 201 charts were reviewed; of those patients, 121 had urinalysis results. Forty-one of those patients (33%) had proteinuria on the first urinalysis; 14 of those patients had a second urinalysis performed, nine subsequently had no proteinuria. Of the 41 patients with proteinuria, 21 patients were on one blood pressure medication, six were on two medications, and 14 were not taking any blood pressure medications (two of those patients had blood pressure medications initiated during the index admission).

Mean systolic blood pressure and diastolic blood pressure among those with proteinuria ≥3 (n=7) were higher than among those with proteinuria ≤2 (n=33), and higher than the total cohort (P<.001). Proteinuria was found in 35% (n-20) of patients diagnosed with chronic hypertension compared with 5% of patients without chronic hypertension. Blood pressure control was inadequate in 53% of patients with chronic hypertension.

“Proteinuria is prevalent, more severe in those with chronic hypertension, and only 47% of inpatients with chronic hypertension had proper blood pressure control. Our findings suggest that detection of proteinuria on admission presents an opportunity to identify patients eligible for quality improvement projects regarding optimization of chronic hypertension,” the researchers concluded.

Source: Carson MP, Mansur S, Sidiqqui K, Kaunzinger C, Asif A. Prevalence of proteinuria in hospitalized patients: A marker of uncontrolled hypertension. Abstract of a poster presented at the National Kidney Foundation 2018 Spring Clinical Meetings, April 10-14, 2018, Austin, Texas.