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Examines the association between oral contraceptive use or hormone replacement therapy (HRT) and microalbuminuria. Characteristics of women with microalbuminuria based on their menopausal status; Potential effects of HRT on cardiovascular morbidity and mortality.

Objective: To gain insight into the psychosocial consequences of a screening programme on the progression of heart, vascular and kidney damage. Design: Over 85,000 people aged 28–75 were invited to participate in a screening for albuminuria. Nearly half of them sent in their morning urine of which almost 10,000 had a (slightly) elevated urinary albumin level. This latter group was invited to participate in a follow-up screening (24-hour urine samples, blood pressure, glucose, cholesterol) together with ±3,000 randomly selected subjects with a normal urinary albumin concentration. A questionnaire on the psychosocial consequences of the screening was sent to 335 participants of the screening programme each of whom had received their (positive or negative) screening results two weeks previously. Results: The response rate was 75%. A minority of the respondents, diagnosed for risk factors, expressed some concern. No influence on the well-being of this group of participants could be established. Almost one third of the respondents claimed to follow a healthier lifestyle as a result of the screening. There are, however, also indications for a certain ‘certificate of health effect’: about half of the smokers and the physically inactive considered that the favourable screening results legitimated their unhealthy lifestyle. An unfavourable screening result led to additional medical consumption in almost half of the respondents. The respondents appreciated the screening and especially the less educated had a very positive attitude towards early diagnosis in general. Conclusions: Those screened positive showed no diminished well-being; their health behaviour improved because of the screening and their medical consumption increased. Many of those screened negative considered the test result a reason to continue their unhealthy lifestyle. [ABSTRACT FROM AUTHOR]

Background: Smoking induces albuminuria and accelerates progression to renal failure in persons with diabetes, but little is known about the relation between smoking and renal function in nondiabetic persons.Objective: To investigate whether smoking is related to albuminuria and abnormal renal function in nondiabetic persons.Design: Cross-sectional study.Setting: Groningen, The Netherlands.Participants: 7476 participants in the PREVEND (Prevention of REnal and Vascular ENd stage Disease) Study.Measurements: Microalbuminuria and high normal albuminuria were defined as urinary albumin excretion of 30 to 300 mg/24 h and 15 to 30 mg/24 h, respectively. Elevated or decreased glomerular filtration rate (GFR) was defined as a creatinine clearance that exceeded or was less than two times the standard deviation of the mean value in nondiabetic, nonsmoking participants who had an albumin excretion of 0 to 15 mg/24 h, adjusted for age and sex.Results: Current smokers had a higher median albumin excretion than nonsmokers and were more likely to have microalbuminuria and high normal albuminuria with elevated or decreased GFR. After adjustment for several potential confounding factors, persons who smoked 20 or fewer cigarettes/d and persons who smoked more than 20 cigarettes/d, respectively, showed a dose-dependent association between smoking and high normal albuminuria (relative risk, 1.33 [95% CI, 1.10 to 1.61] and 1.98 [CI, 1.49 to 2.64]), microalbuminuria (relative risk, 1.92 [CI, 1.54 to 2.39] and 2.15 [CI, 1.52 to 3.03]), elevated GFR (relative risk, 1. 82 [CI, 1.31 to 2.53] and 1.84 [CI, 1.12 to 3.02]), and decreased GFR (relative risk, 1.53 [CI, 1.04 to 2.24] and 1.83 [CI, 1.05 to 3. 20]), respectively. Quitting smoking was associated only with microalbuminuria.Conclusions: Smoking is associated with albuminuria and abnormal renal function. However, these associations are less pronounced or absent in former smokers. [ABSTRACT FROM AUTHOR]