CHICAGO—Microalbuminuria has been increasing in prevalence since 2001 among obese but otherwise healthy individuals in the United States, new data presented at the American Society of Nephrology’s Kidney Week 2016 meeting suggest. Risk factors for albuminuria in these individuals may be distinct from traditional risk factors, researchers concluded.
“Physicians who find their obese patients to be generally healthy may not consider screening for albuminuria, although obesity itself is a risk factor for albuminuria and kidney disease,” lead investigator Meera N. Harhay, MD, told Renal & Urology News. “Physicians may [want to] consider screening obese and morbidly obese adults for albuminuria regardless of the absence of other co-existing medical conditions like diabetes or hypertension.”
Using 2001 to 2014 data from the National Health and Nutrition Examination Survey (NHANES), Dr Harhay, of Drexel University College of Medicine in Philadelphia, and colleagues identified 3180 obese adults (body mass index [BMI] 30 kg/m2 or higher) who had no evidence of other commonly assessed albuminuria risk factors, such as diabetes, hypertension, or reduced kidney function. The prevalence of microalbuminuria (spot urine albumin/creatinine above 30 but less than 300 mg/g) in the healthy obese individuals, who accounted for 24% of all obese NHANES participants, increased significantly from 3.2% in 2001–2002 to 8.1% in 2013–2014, Dr Harhay and her colleagues reported. Among morbidly obese individuals (BMI 40 kg/m2 or higher) in the healthy cohort, the prevalence of microalbuminuria rose from 3.4% in 2001–2002 to 13.5% in 2013–2014.
On multivariable analysis, these findings do not seem to be explained by rates of smoking, poverty, or other traditional risk factors in the healthy group.
The prevalence of microalbuminuria among obese individuals with comorbidities remained stable over the study period. It was 8.5% in 2013–2014.
“We need more studies to investigate the natural history of microalbuminuria in this population,” Dr Harhay said, “and to improve awareness of the potential vascular complications of obesity even in non-diabetic, non-hypertensive patients.”
- Harhay MN et al. Prevalence and trends of albuminuria among obese US adults without other comorbid conditions. Presented in poster format at Kidney Week 2016 in Chicago, Nov. 15-20.