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Assessment of Kidney Function in Mouse Models of Glomerular Disease
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Does microalbuminuria predict diabetic nephropathy?

B P Tabaei1, A S Al-Kassab, L L Ilag

  • 1Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI 48109-0354, USA.

Diabetes Care
|August 28, 2001
PubMed
Abstract

Insights

Microalbuminuria (MA) may not be a reliable predictor of diabetic nephropathy (DN). Poor glycemic control and diabetes duration are linked to MA development and progression, indicating a need for better risk markers.

Area of Science:

  • Nephrology
  • Endocrinology
  • Diabetology

Background:

  • Microalbuminuria (MA) is a known indicator of early kidney damage in diabetes.
  • Diabetic nephropathy (DN) is a major complication of diabetes mellitus.
  • The predictive value of MA for DN requires further investigation.

Purpose of the Study:

  • To identify risk factors for microalbuminuria (MA) in diabetic patients.
  • To assess the predictive accuracy of MA for diabetic nephropathy (DN).
  • To determine factors influencing the development and progression of MA.

Main Methods:

  • Prospective longitudinal study of diabetic subjects with and without MA.
  • Baseline and 7-year follow-up examinations.
  • Analysis of urinary albumin-to-creatinine ratios in multiple urine sample types.

Main Results:

  • MA regressed in 56% of subjects and developed in 16% of controls.
  • Positive predictive value of MA for DN was 43%; negative predictive value was 77%.
  • Poor glycemic control and diabetes duration (10-14 years) correlated with MA incidence and progression.

Conclusions:

  • MA's sensitivity and specificity as a DN predictor may be lower than previously thought.
  • Current markers may be insufficient for optimal clinical management of DN.
  • Further research into novel risk markers for DN is warranted.

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