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How to predict nephropathy in type 1 diabetic patients
Rabinarayan Dash1, Ole Torffvit
1Department of Rheumatology, University Hospital, SE-221 85 Lund, Sweden.
Scandinavian Journal of Urology and Nephrology
|November 5, 2003
Summary
A fixed heart rate exercise test is more predictive of diabetic nephropathy than a fixed workload test. High systolic blood pressure during this test indicates increased risk of microalbuminuria and macroalbuminuria.
Area of Science:
- Nephrology
- Endocrinology
- Cardiovascular Physiology
Background:
- Diabetic nephropathy is a major complication of diabetes mellitus.
- Early detection of diabetic nephropathy is crucial for intervention.
- Exercise testing can reveal subclinical cardiovascular and renal changes.
Purpose of the Study:
- To determine if exaggerated blood pressure and albuminuria during exercise precede microalbuminuria.
- To identify which exercise test is most predictive of diabetic nephropathy.
Main Methods:
- 33 insulin-dependent diabetic men and 34 controls underwent fixed workload and fixed heart rate exercise tests.
- Urinary albumin excretion, heart rate, and blood pressure were measured.
- Follow-up was for an average of 13.1 years to monitor for diabetic nephropathy.
Main Results:
- Diabetic patients who developed nephropathy had higher systolic blood pressure and albumin excretion during the fixed heart rate test compared to controls and healthy diabetics.
- These differences were not observed during the fixed workload test.
- Sixteen patients developed microalbuminuria or macroalbuminuria; two required dialysis.
Conclusions:
- A fixed heart rate exercise test is superior for predicting diabetic nephropathy.
- Elevated systolic blood pressure during a fixed heart rate test is linked to the development of micro- and macroalbuminuria.