NDLI: Predictive value of microalbuminuria in patients with insulin-dependent diabetes of long duration.

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Predictive value of microalbuminuria in patients with insulin-dependent diabetes of long duration.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Ekstrand, A. Groop, P. H. Groop, L. C. Forsblom, C. M.
Description	Author Affiliation: Forsblom CM ( Fourth Department of Medicine, Helsinki University Hospital, Finland.);
Abstract	OBJECTIVE--To investigate the predictive value of microalbuminuria (albumin excretion rate 30-300 mg/24 h) as a risk factor for overt diabetic nephropathy in patients with longstanding insulin dependent diabetes. DESIGN--10 year follow up of patients with normoalbuminuria (albumin excretion rate < 30 mg/24 h), microalbuminuria (30-300 mg/24 h), and macroalbuminuria (> 300 mg/24 h) based on two out of three timed overnight urine samples. SETTING--Outpatient clinic of Helsinki University Hospital. SUBJECTS--72 consecutive patients who had had insulin dependent diabetes for over 15 years. MAIN OUTCOME MEASURES--Urinary albumin excretion rate, mortality, and prevalence of diabetic complications after 10 years. RESULTS--56 patients were re-examined at 10 year follow up, 10 had died, five were lost to follow up, and one was excluded because of non-diabetic kidney disease. At initial screening 22 patients had macroalbuminuria, 18 had microalbuminuria, and 26 had normal albumin excretion. Only five (28%, 95% confidence interval 10% to 54%) of the microalbuminuric patients developed macroalbuminuria during the 10 year follow up and none developed end stage renal failure. Two (8%, 1% to 25%) normoalbuminuric patients developed macroalbuminuria and four (15%, 4% to 35%) became microalbuminuric. Seven (32%, 14% to 55%) of the macroalbuminuric patients developed end stage renal failure and six (27%, 11% to 50%) died of cardiovascular complications. CONCLUSION--Microalbuminuria is not a good predictor of progression to overt nephropathy in patients with longstanding insulin dependent diabetes.
ISSN	09598138
e-ISSN	17561833
Journal	BMJ (British Medical Journal)
Issue Number	6861
Volume Number	305
Language	English
Publisher	British Medical Journal Publishing Group
Publisher Date	1992-01-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Albuminuria Complications Diabetes Mellitus, Type 1 Diabetic Nephropathies Etiology Urine Follow-Up Studies Prognosis Risk Factors Research Support, Non-U.S. Gov't Medicine
Content Type	Text
Resource Type	Article

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