Predictors of microalbuminuria in individuals with insulin dependent diabetes mellitus (DDM). An update
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:109A 1997
Twenty years after the recognition that microalbuminuria is a marker for more serious proteinuria followed by azotemia in type 1 diabetic nephropathy, the value of this sign in type 2 diabetes, hypertension, and other renal disorders has been established. In this interval report from the Pittsburgh Epidemiology of Complications Study, patients with childhood-onset IDDM were followed every 2 years. Initial diagnosis of IDDM was made in 1950-1980, and follow- up for purposes of this study began in 1986-1988. This abstract reports the results of the initial 6 -year follow-up on these patients.
Patients were classified as normoalbuminuric (< 20 µg/min) ir microalbuminuric (20-200 µg/min). Those who were initially normoalbuminuric were then divided into two groups, depending on whether or not they developed microalbuminuria on follow-up at 4 and 6 years. Those who did become microalbuminuric had higher baseline glycosylated hemoglobin levels, as well as higher baseline levels of triglycerides, apoprotein B, and fibrinogen. Also, baseline creatinine clearance was lower in those destined to become microalbuminuric. In particular, the level of glycosylated hemoglobin was shown to be a significant predictor of subsequent microalbuminuria.
Comment: From this study two key inferences can be drawn: 1) Even after 17 years of normalbuminuria in type 1 diabetes, microalbuminuria (presumably leading to the risk of ultimate ESRD) may still supervene. 2) The degree of metabolic control in diabetes is a direct correlate of progression of nephropathy. Undetermined, however, is the issue of whether the same genetic predisposition to diabetes also modulates the extent of hyperglycemia and thus the risk of nephropathy. In other words, poor glucose regulation in some may be the fault of the genes causing diabetes and not the consequence of less diligent adherence to an intensive insulin control regimen. (Eli Friedman, M.D., SUNY Health Science Center, Brooklyn, NY)
To go back use the BACK button on your browser. Otherwise click on the desired link to this article below:
ASN 30th Annual Meeting, San Antonio
Proteinuria/Hematuria : Diabetes