Association of Serum Uric Acid and Microalbuminuria in Essential Hypertension: A Cross-Sectional Study

Abstract

Background: Hypertension is a leading contributor to cardiovascular and renal morbidity worldwide, and subclinical target-organ damage such as microalbuminuria (MAU) often precedes overt complications. Serum uric acid (SUA) has been implicated in endothelial dysfunction and nephrosclerosis, but data establishing its association with microalbuminuria in Indian patients with essential hypertension remain limited. Methods: This hospital-based cross-sectional study was conducted among 100 in-patients and out-patients with essential hypertension attending a tertiary care centre over 18 months. Patients aged 18–80 years were enrolled by purposive sampling after excluding those with chronic kidney disease, diabetes mellitus, hypothyroidism, renal artery disease, and other endocrine causes of hypertension. All participants underwent clinical evaluation, serum uric acid estimation, and urine protein–creatinine ratio testing for microalbuminuria, along with renal function tests and relevant imaging. Hyperuricemia was defined as SUA >7.0 mg/dl in males and >6.0 mg/dl in females. Association between hyperuricemia and microalbuminuria was assessed using the Chi-square test, and mean SUA levels between groups were compared using Student's t-test, with p<0.05 taken as statistically significant. Results: The mean age of participants was 53.45 ± 11.657 years, with 71% males. Hyperuricemia and microalbuminuria were present in 22% and 24% of participants, respectively. Among participants with hyperuricemia, 86.4% had microalbuminuria compared with 6.4% of those without hyperuricemia, a statistically significant association (p<0.001). The mean SUA level was significantly higher in participants with microalbuminuria (7.300 ± 0.4374 mg/dl) than in those without (5.108 ± 1.0179 mg/dl; p<0.001). Conclusion: Serum uric acid is significantly associated with microalbuminuria in patients with essential hypertension. Hyperuricemia may serve as an accessible, low-cost marker to identify hypertensive patients at higher risk of renal and cardiovascular target-organ damage, supporting its role in risk stratification and early intervention.

Keywords: Serum uric acid; Microalbuminuria; Hyperuricemia; Essential hypertension; Target organ damage