Related Experiment Video
Updated: Jul 20, 2026
05:26
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Albuminuria, a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy
Dick de Zeeuw1, Giuseppe Remuzzi, Hans-Henrik Parving
1Department of Clinical Pharmacology, Groningen University Medical Center, Ant Deusinglaan 1, 9713 AV Groningen, Netherlands. d.de.zeeuw@med.rug.nl
Circulation
|August 11, 2004
Summary
Reducing albuminuria early in type 2 diabetic patients with nephropathy significantly lowers cardiovascular risk. This early albuminuria reduction predicts long-term cardioprotection from renin-angiotensin system (RAS) interventions.
Area of Science:
- Nephrology
- Cardiology
- Diabetology
Background:
- Albuminuria is a key risk marker for cardiovascular and renal events.
- Renin-angiotensin system (RAS) inhibitors effectively reduce albuminuria.
Purpose of the Study:
- To determine if short-term, drug-induced changes in albuminuria predict long-term cardiovascular protection from RAS intervention.
Main Methods:
- Analysis of data from the RENAAL trial (1513 type 2 diabetic patients with nephropathy).
- Focused on the relationship between cardiovascular endpoints and baseline/reduced albuminuria.
- Modeled the impact of initial 6-month changes in albuminuria on cardiovascular outcomes.
Main Results:
- High baseline albuminuria (>3 g/g creatinine) significantly increased cardiovascular (1.92-fold) and heart failure (2.70-fold) risk.
- Albuminuria was the strongest baseline predictor of cardiovascular outcome.
- A 50% reduction in albuminuria predicted an 18% decrease in cardiovascular risk and a 27% decrease in heart failure risk.
Conclusions:
- Albuminuria is a critical predictor of cardiovascular risk in type 2 diabetic nephropathy.
- Achieving albuminuria reduction within the first 6 months offers significant cardiovascular protection.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
01:15Diabetes: Management and Pharmacotherapy
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
01:26Type II Diabetes I: Introduction
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
01:29Hyperglycemia
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
01:27Diabetic Retinopathy
DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...