Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

The predictive value of microalbuminuria in IDDM. A five-year follow-up study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Glycaemic variability and hypoglycaemia are associated with C-peptide levels in insulin-treated type 2 diabetes

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Psychosocial factors and HbA1c in people with insulin-pump treated type 1 diabetes: Protocol for an ongoing systematic literature review

    Publikation: KonferencebidragKonferenceabstrakt til konferenceForskningpeer review

  3. Glucose Sensor Accuracy After Subcutaneous Glucagon Injections Near to Sensor Site

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Effect of the incretin hormones on the endocrine pancreas in end-stage renal disease

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

OBJECTIVE: To investigate the predictive value of microalbuminuria and the annual increase of albumin excretion as risk factors for diabetic nephropathy.

RESEARCH DESIGN AND METHODS: A 5-year follow-up of patients with microalbuminuria (urinary albumin excretion [UAE] = 30-299 mg/24 h) and matched patients with normoalbuminuria (UAE < 30 mg/24 h). The initial classification was based on one single 24-h urine collection. The annual increase in UAE was calculated by linear regression analysis of log-transformed UAE on time. This study was conducted at the outpatient clinic of the Steno Diabetes Center. The study subjects included 118 insulin-dependent diabetes mellitus (IDDM) patients between 18 and 50 years of age with microalbuminuria and 112 matched control patients with normal UAE with an age at diabetes onset of < 31 years. The main outcome measures were UAE, annual change in UAE rate (percentage per year), and the prevalence of retinopathy.

RESULTS: After 5 years, 39 (33%, 24-42 CI [95% confidence interval]) patients with microalbuminuria had normoalbuminuria, 57 (48%, 38-57 CI) still had microalbuminuria, and 22 (19%, 12-27 CI) had developed diabetic nephropathy. Among the 112 patients with normoalbuminuria in 1985, 9 (8%, 4-15 CI) had developed microalbuminuria, and 2 (2%, 0-6 CI) had developed diabetic nephropathy. Of the 79 patients with persistent albuminuria, only 36 (46%, 34-57 CI) were progressors with a rate of progression of > 5%/year. Progressors had significantly higher HbAlc, higher mean blood pressure, and a higher incidence of proliferative retinopathy compared with nonprogressors. Multiple regression analysis only identified mean HbAlc as an independent predictor of the rate of progression. Smoking was significantly more prevalent in patients with persistent albuminuria.

CONCLUSIONS: Microalbuminuria is a predictor of progression to diabetic nephropathy; however, not as strong as suggested previously. Calculation of the annual increase in UAE seems to be a more specific method of identifying patients who will develop diabetic nephropathy.

OriginalsprogEngelsk
TidsskriftDiabetes Care
Vol/bind17
Udgave nummer2
Sider (fra-til)120-5
Antal sider6
ISSN0149-5992
StatusUdgivet - feb. 1994

ID: 44940161