Assessment and comparison of microalbuminuria in obese and nonobese children

Introduction

Microalbuminuria is an increase in urinary albumin excretion (30–300 mg/day) or the microalbumin/creatinine ratio (30–300 mg/g) in a spot urine sample.¹ Approximately 15–20% of diabetic people have microalbuminuria.² Adolescents are more likely than adults to have microalbuminuria.³

In illnesses linked to lifestyle choices, microalbuminuria raises the risk of dementia, cardiovascular disease, mortality, and renal failure.⁴ The metabolic syndrome and microalbuminuria are closely connected.⁵ Regardless of the glomerular filtration rate, the availability of ongoing microalbuminuria leads to the existence of chronic kidney disease (CKD).⁶ In diabetic individuals, microalbuminuria may also be a sign of the acute phase response. However, it is thought that microalbuminuria results from the acute phase in addition to being an inaccurate marker for sudden conditions like sepsis, trauma, burns, and ischemic injuries like myocardial infarction, it is also said to be a reaction to inflammatory mediators. In this regard, it may offer a more durable and accessible compared to other acute phase characteristics.⁷

The prevalence of microalbuminuria among Asian, European, and US populations has been estimated at 5.0, 6.7, and 5.0-7.8%, respectively.⁸ Microalbuminuria could be detected in patients with acute stroke.⁹ Increased albumin throughput over the glomerular filtration barrier results in microalbuminuria. Hypertension is the primary risk part for microalbuminuria in the common people, which is also related with a 25% prevalence of microalbuminuria.¹⁰

Microalbuminuria is a marker for dysfunctional endothelial cells and a predictor of cardiovascular disease events.¹¹

Microalbuminuria has received widespread recognition as an independent predictor of renal dysfunction.¹² The future appearance of microalbuminuria in type 1 diabetes is predicted by waist circumference.¹³

In primary hypertension, the development of microalbuminuria likely reflects glomerular injury.¹⁴

Microalbuminuria is examined as a primary nonspecific marker of inflammation.¹⁵

Microalbuminuria is a measure of long-term kidney disorder that is also progressing cv morbidity and mortality show the presence of renal target organ damage when it exists in clinical situations including long-term kidney disorder, diabetes, or hypertension (HTN).¹⁶

Although the majority of subclinical atherosclerosis markers were not statistically affected by microalbuminuria, the presence of carotid plaque was substantially correlated with the rising value of microalbuminuria.¹⁷

Higher urine microalbuminuria levels and decreased estimated glomerular filtration rate (egfr) are separate liableness for the development of heart stoppage and death in patients with existing heart failure.¹⁸

Microalbuminuria is the first stage of diabetic nephropathy development, and it can advance to clear proteinuria and eventually last-phase renal disease.¹⁹

Methods

The following study will be performed in collaboration on behalf of Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi (Meghe), Wardha, in the Biochemistry division of the Department of Biochemistry, Jawaharlal Nehru Medical College (JNMC), Sawangi (Meghe), from 07 feb 2023 to 2024. If the Committee of Institutional Ethics approves the study and the patients agree, written consent form is taken from the patients for the study then the research will proceed.

Discussion

In the study of Iroro Enameguolo Yarhere, on Children with type 1 diabetes mellitus, he concluded that protein can be detected down to 10–20 mg/dl on a standard urine dipstick. Children who have type 1 diabetes and who avoid regular gain to insulin are expected to have the development of chronic renal problems earlier which manifest as microalbuminuria. Children with type 1 diabetes who avoid regularly gaining insulin are likely to have the development of life-chronic renal problems earlier and manifest as microalbuminuria. It is important to make sure that these kids don’t continue to suffer from their deficiency, and the healthcare system will do everything it can to make sure that these kids get insulin regularly.²⁰

Byung Ok Kwak studied Microalbuminuria in children with urinary tract infections. They looked into how factors like age, height, weight, blood pressure, glomerular filtration rate (GFR), and gender correlated with the ratio of children with autism renal scar, hematuria, vesicoureteral reflux, renal parenchymal abnormality, and their propensity to cause UTI problems the judgment is that: In comparison to healthy children, children with UTI had significantly higher spot urine microalbumin/creatinine ratios, which were positively coordinate with GFR. This ratio may be used as a predictive and prescreening indicator in UTI patients. The predictability of microalbuminuria in pediatric UTI patients has to be further investigated.¹

The study Martin Majlund Mikkelsen on Microalbuminuria and short-term prognosis in patients undergoing cardiac surgery was studied to determine if patients undergoing elective cardiothoracic surgery have a higher risk of negative outcomes if they had preoperative microalbuminuria (MA). They concluded that the presence of MA before surgery in patients having elective cardiothoracic surgery was not related to a wide variety of prior postoperative results and that including MA details would not enhance the perfection of the additive euro score. They concluded that the early postoperative outcomes of patients having elective cardiothoracic surgery were not significantly correlated with the preoperative presence of MA, and including details on MA will not enhance the perfection of the additive euro score. They observed that there was no association between the existence of MA before surgery in patients receiving elective cardiothoracic surgery and a wide range of early postoperative outcomes.⁵

Ian H. De Boer studied Central Obesity, Incident Microalbuminuria, And Change in Creatinine Clearance in the Epidemiology of Diabetes Interventions and Complications they concluded that the emergence of microalbuminuria in type 1 diabetes is predicted by waist circumference.¹³

The study of Alex Chang on lifestyle-related factors, obesity, and incident Microalbuminuria concluded that obesity and eating a poor diet are linked to the incidence of microalbuminuria.⁶

N Mahmud studied Microalbuminuria in inflammatory bowel disease he concluded that all individuals with active inflammatory bowel disease have abnormally high levels of microalbuminuria, and the levels decrease when the condition is dormant. Microalbuminuria, which is most likely the result of a quick condition response, offers a quick, easy, and affordable test that may be used to track the progression of inflammatory bowel disease and how well it is responding to treatment.⁷

Ethical approval and consent

Approved by the Institutional Ethics Committee Datta Meghe Institute of Higher Education and Research Ref. No. DMIHER (DU)/IEC/2023/613 dated on 06/02/2023.

Written consent form is taken from the patients for the study then the research will proceed.