Prevalence and risk factors of elevated urinary albumin-to-creatinine ratio in a Thai academic population

Abstract

Background: The urinary albumin–to–creatinine ratio (UACR) is a key marker for early kidney dysfunction. This study assessed UACR levels and their associations with demographic and clinical factors in a Thai university population. Materials and methods: A cohort of 158 participants (53 males, 105 females) was recruited from Chiang Mai University between January and May 2024. Urinary albumin and creatinine were measured by turbidimetric immunoassay and creatininase method, respectively, and expressed as UACR (mg/gm creatinine). UACR was categorized as normoalbuminuria (<30 mg/gm creatinine), microalbuminuria (30-299 mg/gm creatinine), or clinical albuminuria (≥300 mg/gm creatinine). Data on body mass index (BMI), blood pressure, fasting blood glucose, physical activity, use of supplements or medications, and the presence of chronic conditions were also collected. Results: Most participants (94.3%) had normoalbuminuria, whereas microalbuminuria and clinical albuminuria were observed in 4.4% and 1.3% of participants, respectively. Overall, 71.5% were normotensive and 28.5% hypertensive. Based on BMI, 41.1% had normal weight, 18.4% were overweight, and 34.8% were obese. Nearly half reported no regular exercise, and the majority were non–smokers (98.1%) and non–drinkers (83.5%). Regular supplement or medication use was reported by 57.0%, mainly vitamins/minerals and fish oil. Chronic diseases occurred in 37.3%, with hypercholesterolemia (10.8%) and hypertension (8.9%) being most common. Hypercholesterolemia, hypertension, allergy, type II diabetes, lifestyle factors, and supplement or medication use were not associated with albuminuria (Chisquare, p>0.05), whereas obesity class II, elevated fasting blood glucose (≥126 mg/dL) and systemic lupus erythematosus (SLE) were significantly associated with increased urinary albumin excretion (Chi-square, p<0.05). Conclusion: Elevated blood glucose, obesity, and SLE were significantly linked to increased UACR, emphasizing the importance of early identification and management of these risk factors to prevent kidney disease progression.