TITLE:
Microalbuminuria in pediatric patients with hypertension
AUTHORS:
Nataša Marčun Varda
KEYWORDS:
Microalbuminuria; Hypertension; Cardiovascular Diseases; Child
JOURNAL NAME:
Health,
Vol.5 No.4A,
April
19,
2013
ABSTRACT: Microalbuminuria in adults has been found to be an early indicator of
both renal and systemic vascular disease, as well as significant cardiovascular
risk predictor and therapeutic marker. Its role in essential hypertension in
adults has also been well established. As diseases like hypertension and
obesity have their roots in childhood and are already present in children,
influencing the morbidity in adulthood, the role of microalbuminuria has been
extensively investigated in children as well. Most investigations have been
performed in diabetic children, confirming its clinical significance. There is
also enough evidence to suggest that
microalbuminuria in obese children should be taken as seriously as
in children with diabetes. In children with hypertension rare studies also indicate
that its presence identifies hypertensive
children with higher risk, although the exact role has to be confirmed
in prospective and larger studies. The mechanisms of microalbuminuria onset
could be the result of renal damage secondary to hypertension or underlying renal and systemic endothelial
dysfunction. Evidence from small intervention studies in children with
microalbuminuria also suggests that early intervention with antihypertensive
drugs is likely to be beneficial, pointing out the role of microalbuminuria
as a therapeutic marker in children too. In addition, we have to stress the
importance of follow-up of children with microalbuminuria, confirmation of
its persistence and identification of progression. However, longitudinal prospective
studies in children, investigating its future cardiovascular risk, are still
lacking.