Formation and progression of microalbuminuria

Relevance. Microalbuminuria (MAU) is a symptom diagnosed in kidney pathology, cardiovascular and other diseases. The study of the processes of development and progression of MAU will bring closer the solution of problems of nephrology, cardiology and pathological cardiorenal relationships.
Objective. To study the development t and progression of MAU.
Design and methods. Using the data from 6‑year follow-up of 22 clinical and anamnestic indicators of initially healthy 7,959 men (workers of locomotive crews) 18–66 years old, found out the origin of MAU and the progression of this pathological symptom. We used a confusion matrix, a multivariate regression model, relative risk assessment, Kaplan-Meier models and Cox proportional hazards model.
Results. MAU was determined to be due to arterial hypertension, excessive alcohol consumption, dyslipidemia, family history of early cardiovascular disease, I–II degree retinopathy, and smoking. In our analyses, these predictors showed statistical heterogeneity. Thus, specific characteristics of the predictors were established that can be used for their ultrastructural or biochemical identification at the cellular level and identification of their damage effect.
Conclusions. The course of endothelial dysfunction under the influence of MAU predictors varies considerably and depends on the effect of a particular factor, a set of predictors or all predictors taken together when they are involved simultaneously. These data show the need to find out ultrastructural and biochemical specific markers and their quantitative values of renal endothelial dysfunctions occurring under the influence of MAU predictors, during the development and progression of this pathological symptom in order to restore the normal function of the endothelial cell and the affected organ, as a whole as long, as there is still room for therapeutic efforts.

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