Predicting diabetic nephropathy in insulin-dependent patients
- PMID: 6738599
- DOI: 10.1056/NEJM198407123110204
Predicting diabetic nephropathy in insulin-dependent patients
Abstract
We studied whether microalbuminuria (urinary albumin excretion rates of 15 to 150 micrograms per minute) would predict the development of increased proteinuria in Type I diabetes. We also studied the influence of glomerular filtration rate, renal blood flow, and blood pressure on the later development of proteinuria. Forty-four patients who had had Type I diabetes for at least seven years and who had albumin excretion rates below 150 micrograms per minute were studied from 1969 to 1976, and 43 were restudied in 1983. Of the 14 who initially had albumin excretion rates at or above 15 micrograms per minute, 12 had clinically detectable proteinuria (over 500 mg of protein per 24 hours) or an albumin excretion rate above 150 micrograms per minute at the later examination. Of the 29 who initially had albumin excretion rates below 15 micrograms per minute, none had clinically detectable proteinuria at the later examination, although four had microalbuminuria. Those whose condition progressed to clinically overt proteinuria had elevated glomerular filtration rates and higher blood pressures at the initial examination than did those in whom proteinuria did not develop. Renal blood flow was not elevated in these patients. We conclude that microalbuminuria predicts the development of diabetic nephropathy and that elevated glomerular filtration rates and increased blood pressure may also contribute to this progression.
Similar articles
-
Development and progression of renal disease in Pima Indians with non-insulin-dependent diabetes mellitus. Diabetic Renal Disease Study Group.N Engl J Med. 1996 Nov 28;335(22):1636-42. doi: 10.1056/NEJM199611283352203. N Engl J Med. 1996. PMID: 8929360
-
[Diabetic nephropathy: significance of microalbuminuria and proteinuria in Type I and Type II diabetes mellitus].Praxis (Bern 1994). 1995 Oct 31;84(44):1265-71. Praxis (Bern 1994). 1995. PMID: 7491450 Review. German.
-
Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes.N Engl J Med. 1984 Feb 9;310(6):356-60. doi: 10.1056/NEJM198402093100605. N Engl J Med. 1984. PMID: 6690964
-
Relationships among microalbuminuria, insulin resistance and renal-cardiac complications in insulin dependent and non insulin dependent diabetes.Exp Clin Endocrinol Diabetes. 1997;105 Suppl 2:1-7. doi: 10.1055/s-0029-1211783. Exp Clin Endocrinol Diabetes. 1997. PMID: 9288531 Review.
-
Studies of cardiovascular and renal function in subclinical and manifest diabetic nephropathy.Acta Med Scand Suppl. 1988;722:1-69. Acta Med Scand Suppl. 1988. PMID: 3163465
Cited by
-
Association testing of previously reported variants in a large case-control meta-analysis of diabetic nephropathy.Diabetes. 2012 Aug;61(8):2187-94. doi: 10.2337/db11-0751. Epub 2012 Jun 20. Diabetes. 2012. PMID: 22721967 Free PMC article.
-
The causal relationship between COVID-19 and estimated glomerular filtration rate: a bidirectional Mendelian randomization study.BMC Nephrol. 2024 Jan 15;25(1):21. doi: 10.1186/s12882-023-03443-4. BMC Nephrol. 2024. PMID: 38225574 Free PMC article.
-
First morning urinary albumin concentration is a good predictor of 24-hour urinary albumin excretion in children with type 1 (insulin-dependent) diabetes.Diabetologia. 1986 Feb;29(2):97-9. doi: 10.1007/BF00456117. Diabetologia. 1986. PMID: 3699303
-
The development and progression of chronic renal disease. Can it be prevented or attenuated?Drugs. 1988;35 Suppl 6:78-82. doi: 10.2165/00003495-198800356-00011. Drugs. 1988. PMID: 3042362 Review.
-
Renal vessel changes in diabetic KK-mice.Virchows Arch A Pathol Anat Histopathol. 1986;409(5):669-78. doi: 10.1007/BF00713432. Virchows Arch A Pathol Anat Histopathol. 1986. PMID: 3092462
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical