Clinical Profile and Predictors of Proteinuria in patients with Hypertension

Abstract

Background:Hypertension is a major cause of cardiovascular and renal morbidity. Proteinuria is an important marker of renal involvement and hypertension-mediated target-organ damage and is associated with increased risk of chronic kidney disease progression. Early identification of hypertensive patients at risk of proteinuria may facilitate timely intervention.Objective:To evaluate the clinical and laboratory profile of patients with hypertension and identify factors independently associated with proteinuria.Methods:A hospital-based observational cross-sectional study was conducted among 274 adult patients with hypertension. Demographic, clinical, anthropometric, and laboratory parameters were recorded. Blood pressure, duration of hypertension, diabetes mellitus, body mass index, serum creatinine, estimated glomerular filtration rate (eGFR), glycemic parameters, and lipid profile were assessed. Proteinuria was evaluated using the predefined urinary protein assessment method. Patients were categorized into proteinuria-positive and proteinuria-negative groups. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of proteinuria.Results:Among 274 patients, 68 (24.8%) had proteinuria. The mean age of the study population was 58.4 ± 11.2 years. Patients with proteinuria had significantly longer duration of hypertension (11.2 ± 5.7 vs. 7.4 ± 5.1 years; p<0.001) and higher systolic blood pressure (154.6 ± 18.2 vs. 143.1 ± 15.7 mmHg; p<0.001). Diabetes mellitus was more frequent among patients with proteinuria (55.9% vs. 30.1%; p<0.001). Serum creatinine was higher and eGFR was lower in the proteinuria group (p<0.001 for both). On multivariable analysis, longer duration of hypertension, higher systolic blood pressure, diabetes mellitus, and reduced eGFR were independently associated with proteinuria.Conclusion:Proteinuria was present in approximately one-fourth of hypertensive patients. Prolonged hypertension, poor blood-pressure control, diabetes mellitus, and impaired renal function were important independent predictors. Routine assessment of urinary protein and renal function may facilitate early detection of renal involvement in patients with hypertension