Secured 2nd Position at the State Level APICON, 2008 in Competetive Platform Presentation Category.

1. A STUDY ON PREVALENCE AND ETIOLOGICAL BASIS OF ALBUMINURIA IN GERIATRIC PATIENTS: A HOSPITAL BASED STUDY. Presented by Tanoy Bose Co-Authors: Laskar B, Kalita BC, Borah D, Dutta A The Department of Medicine Assam Medical College & Hospital Dibrugarh The APICON : Assam Chapter 2008 Dated: The 29th of November, 2008

3. Although proteinuria has been regarded as "the first sign of serious renal disease", its presence can represent anything from a benign abnormality to the signpost of significant disease,1 with the potential for progressive renal insufficiency.

4. Because of the variable significance and multiple causes of proteinuria, the clinician requires a systematic approach for the work-up of this condition in the older patient. 1.Geriatrics & agingVolume 3, Number 10, December 2000, Pages 12, 30

6. The prevalence of proteinuria in the general population is rather low, but it increases considerably in patients with diabetes or hypertension. The natural course of proteinuria is different in patients with diabetic or nondiabetic nephropathy; however its prognostic implications for renal and cardiovascular endpoints are the same, independently from the underlying kidney disease.

7. Both microalbuminuria and proteinuria today are considered risk factors for cardiovascular disease. Moreover, proteinuria is a typical manifestation of overt nephropathy and is associated with faster decline of renal function.

10. Study undertaken in the Department of Medicine , Assam Medical College, Dibrugarh

11. Cases enrolled as per inclusion criteria from indoor patients during the period of August 2006 to July 2007

12. Detail medical history was taken and thoroughly examined for all systems. Routine & special investigations done as & when needed

13. Qualitative & quantitative urinary protein & albumin estimation was done

17. Results: 44% patients were in the age group of 60-65ys. 62.5% had macroscopic albuminuria 72% cases with macroscopic albuminuria were male 92% had subnephrotic range of proteinuria 65% of cases had complaints of terminal dribbling of urine with hesitancy f/b ↑frequency (60%) & burning micturation (50%) Pallor ( 72%) was the most common physical finding followed by poor nutrition (65%) & hypertension (52%)

18. Results continued:

19. Discussion of results In the study the prevalence of proteinuria was found to be 62.5% among geriatric population of hospitalized patients without any sex predilection. [M:F= 1:0.91] Macroscopic albuminuria was more prevalent in the age group of 60-65 years ( 50.57%) but among the 8 patients above 75years all had proteinuria suggesting that the prevalence increases with age

20. Discussion continued…. In the study Urinary tract infection (24%) turned out to be commonest cause of albuminuria followed by diabetic nephropathy (19.3%) Albuminuria due to urinary tract infection was also more common among females (71.4%) with respect to males (26.38%)

21. Discussion continued…. Among other principal causes of albuminuria were Chronic renal failure, Malignancy and Malaria Hypertension was found to be prevalent among 52% of cases but direct attribution of albuminuria to hypertension could not be done due to overlap with DM, UTI and lack of renal biopsy

22. Conclusion Proteinuria is quite frequent among the geriatric indoor patients Though most of them have symptoms suggestive of urinary tract disorder, asymptomatic proteinuric patients were not infrequent (35%) Urinary tract infection followed by diabetic nephropathy was the commonest cause of proteinuria The prevalence of proteinuria increases with age.