Does Microalbuminuria Predict Diabetic Nephropathy?
| Autor: | William H. Herman, Catherine M. Zawacki, Bahman P. Tabaei, Abdul S. Al-Kassab, Liza L. Ilag |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Michigan medicine.medical_specialty Time Factors Adolescent Endocrinology Diabetes and Metabolism Black People Angiotensin-Converting Enzyme Inhibitors Blood Pressure White People Diabetic nephropathy chemistry.chemical_compound Predictive Value of Tests Risk Factors Diabetes mellitus Internal medicine Internal Medicine medicine Albuminuria Humans Diabetic Nephropathies Longitudinal Studies Prospective Studies Child Prospective cohort study Advanced and Specialized Nursing Creatinine Proteinuria business.industry Smoking Middle Aged medicine.disease Surgery Cross-Sectional Studies Diabetes Mellitus Type 1 Diabetes Mellitus Type 2 chemistry Predictive value of tests Hypertension Cohort Disease Progression Microalbuminuria medicine.symptom business Biomarkers Follow-Up Studies |
| Zdroj: | Diabetes Care. 24:1560-1566 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/diacare.24.9.1560 |
| Popis: | OBJECTIVE—To describe risk factors associated with microalbuminuria (MA) in subjects with diabetes, investigate the predictive value of MA as a marker of risk for diabetic nephropathy (DN), and define risk factors associated with the development and progression of MA. RESEARCH DESIGN AND METHODS—We conducted a prospective longitudinal study of 23 diabetic subjects with persistent MA and 209 diabetic subjects without MA who attended diabetes clinics at the University of Michigan Medical Center in 1989 and 1990. Both groups were examined at baseline and after 7 years. At baseline, urinary albumin–to–creatinine ratios were studied in random, first morning, and 24-h urine samples. At follow-up, a 12-h overnight urine sample was collected and analyzed for albumin and creatinine. At baseline, MA was defined by at least two separate urine specimens with albumin–to–creatinine ratios between 30 and 299 μg albumin per milligram of creatinine. RESULTS—MA regressed in 56% of subjects with baseline MA without systematic application of corrective measures and developed in 16% of subjects without baseline MA. The predictive value positive of MA as a marker of risk for DN was 43%, and the predictive value negative was 77%. In the combined cohort, the incidence and progression of MA were significantly associated with poor glycemic control and duration of diabetes between 10 and 14 years. CONCLUSIONS—MA may not be as sensitive and specific a predictor of DN as previously suggested. Other markers of risk for DN are needed for optimal clinical management. |
| Databáze: | OpenAIRE |
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