Hello,

I could repeat all my thoughts on this but I wrote a legthy post on this here in the UKidney news section. Please see the link below:

http://ukidney.com/news/entry/treating-microalbuminuria-to-reduce-cardiovascular-disease-an-increasingly-dangerous-strategy

Happy to address any follow-up questions below once you've had a chance to read it.

Dr. Jordan Weinstein

Hi Thank you.

I did read that review and Dr Glassock's from 2011.

Is there anything more recent.

In a hypertensive patient with Microalbuminuria ( non diabetic ) and no cardiovascular disease what would be an evidence based approach.

thanks again

RK

Hello,

There have been no more recent RCTs to inform this issue.

Personally, in patients with well controlled BP who are on an ACEi or ARB, I no longer escalate the dosage of either nor add aldactone provided the ACR remains no greater than 50 mg / mmol (or so). I also would ensure such patients have had all other modifiable cardiovascular risk factors addressed because more than anything else, the finding of microalbuminuria identifies a patient at risk - even if it doesn't actually mediate this risk.

Dr. Jordan Weinstein