Mikroalbuminurie und Albuminurie: Differenzialdiagnose und therapeutische Konsequenzen

Zusammenfassung

Eine Mikroalbuminurie oder Albuminurie kann Ausdruck einer generalisierten Gefäßschädigung oder einer Nierenerkrankung sein. Die Prävalenz einer Mikroalbuminurie liegt in der Bevölkerung bei etwa 8 %, bei Patienten mit arterieller Hypertonie und Diabetes mellitus erreicht sie sogar 50 % und mehr. Sie ist mit einer Erhöhung der kardiovaskulären Morbidität und Mortalität verbunden. Als zentraler Mechanismus zur kardiovaskulären Protektion können die Blutdruckkontrolle und die Hemmung des Renin-Angiotensin-Aldosteron-System (RAAS) gelten. Damit ist nicht nur eine Verringerung von kardio-vaskulär-renaler Endorganschäden (Herzinsuffizienz, diabetische Nephropathie, zerebrovaskuläre Ereignisse) verbunden, sondern auch der damit assoziierten Mortalität.

Summary

The occurrence of microalbuminuria or albuminuria indicates a disturbance of the barrier function of endothelial cells, basement membrane or of a structural-renal disease (including diseased podocytes). The prevalence of microalbuminuria in the general population is about 8 %, however, in high risk groups, prevalence rates of 50 % and more have been observed. Its incidence is strongly associated with increased cardiovascular morbidity and mortality. Blood pressure control and the blockade of the renin-angiotensin-aldosteron-system (RAAS), respectively, is the central mechanism to reduce cardio-vascular-renal end points as well as mortality.

Schlüsselwörter

Mikroalbuminurie - Albuminurie - Proteinurie

Keywords

microalbuminuria - albuminuria - proteinuria

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