Prevalence and clinical significance of microalbuminuria and hypoxemia in patients with chronic obstructive pulmonary disease

Poonam Gupta, Anand Kumar, Ajeet Kumar Chaurasia, Arvind Gupta


Background: Microalbuminuria is a sign of glomerular dysfunction in general and sign of tubulointerstitial disease to a lesser extent. Hypoxia induces endothelial cell to release a number of different vasoactive agents including endotheline-1, platelet derived growth factor (PDGF), nitric oxide; that causes endothelial injury and lead to microalbuminuria. This study was aimed to assess the prevalence of microalbuminuria in COPD patients and assess the Relationship of microalbuminuria with the disease severity in the forms of FEV1, PaO2, PaCO2, and BODE INDEX in COPD patients.

Methods: Total 130 COPD patients were included in our cross sectional study. Total patients were divided into two groups, 1st group was COPD with microalbuminuria while 2nd group was COPD without microalbuminuria. Lung function test, 6 min walk distance, arterial blood pressure (BP), BODE index, arterial blood gases, fasting and post prandial plasma glucose and kidney function tests were measured. Screening for microalbuminuria was done by measuring urinary microalbumin in a random spot urine collection.

Results: The prevalence of microalbuminuria was 29.23% in patients of COPD. As compared with COPD without microalbuminuria group, COPD with microalbuminuria group were more hypoxic (12% vs 74%, P=0.0001 ), more hypercapnic (22% vs 84%, p=0.00001) and most of the patients with grade III (16% vs 34%, p=0.00001) or grade IV (19% vs 47%, p=0.00001) severity (according to GOLD criteria).

Conclusions: Patients with severe COPD with hypoxemia or hypercapnia were significantly associated with microalbuminuria.


Chronic obstructive pulmonary disease, Hypercapnia, Hypoxemia, Microalbuminuria

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Gold PM. The 2007 GOLD Guidelines: a comprehensive care framework. Respiratory care. 2009;54(8):1040-9.

Pauwels RA, Rabe KF. Burden and clinical features of chronic obstructive pulmonary disease (COPD). Lancet. 2004;364(9434):613-20.

Chapman KR, Mannino DM, Soriano JB, Vermeire PA, Buist AS, Thun MJ, et al. Epidemiology and costs of chronic obstructive pulmonary disease. Euro Resp J. 2006;27(1):188-207.

Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997;349(9064):1498-504.

Rakugi H, Tabuchi Y, Nakamaru M, Nagano M, Higashimori K, Mikami H, et al. Evidence for endothelin-1 release from resistance vessels of rats in response to hypoxia. Biochem Biophysical Res Comm. 1990;169(3):973-7.

Bowen-Pope DF, Hart CE, Seifert RA. Sera and conditioned media contain different isoforms of platelet-derived growth factor (PDGF) which bind to different classes of PDGF receptor. J Bio Chem. 1989;264(5):2502-8.

Adnot S, Raffestin B, Eddahibi S, Braquet P, Chabrier PE. Loss of endothelium-dependent relaxant activity in the pulmonary circulation of rats exposed to chronic hypoxia. J Clin Invest. 1991;87(1):155-62.

Vender RL, Clemmons DR, Kwock L, Friedman M. Reduced oxygen tension induces pulmonary endothelium to release a pulmonary smooth muscle cell mitogen(s). Am Rev Resp Dis. 1987;135(3):622-7.

Ibsen H, Olsen MH, Wachtell K, Borch-Johnsen K, Lindholm LH, Mogensen CE, et al. Reduction in albuminuria translates to reduction in cardiovascular events in hypertensive patients: losartan intervention for endpoint reduction in hypertension study. Hypertension. 2005;45(2):198-202.

Agrawal A, Garg R, Sahu D, Kumar M. Study the association of chronic obstructive pulmonary disease with early endothelial dysfunction and its impact on cardiovascular system by estimating urinary albumin creatinine ratio. Lung India Off Organ Indian Chest Soc. 2017;34(2):138.

Bulcun E, Ekici M, Ekici A, Kisa U. Microalbuminuria in chronic obstructive pulmonary disease. COPD. 2013;10(2):186-92.

Mehmood K, Sofi FA. Microalbuminuria and hypoxemia in patients with COPD. J Pulm Respir Med. 2015;5(280):2.

Sujay J, Gajanan GS. Clinical significance of microalbuminuria and hypoxemia in patients with chronic obstructive pulmonary disease. Indian J Heal Sci Biomed Res (KLEU). 2017;10(1):19.

Casanova C, de Torres JP, Navarro J, Aguirre-JaĆ­me A, Toledo P, Cordoba E, et al. Microalbuminuria and hypoxemia in patients with chronic obstructive pulmonary disease. Am J Resp Crit Care Med. 2010;182(8):1004-10.

Kumar R. Study of microalbuminuria in patients with stable COPD. Ann Int Med Dent Res. 2016;2:95-8.

Celli BR, MacNee WA, Agusti AA, Anzueto A, Berg B, Buist AS, et al, Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Euro Resp J. 2004;23(6):932-46.