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Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes
Abstract:
We studied whether microalbuminuria (30 to 140 micrograms of albumin per milliliter) would predict the later development of increased proteinuria and early mortality in Type II diabetics. During 1973, morning urine specimens of diabetic clinic patients 50 to 75 years of age whose disease had been diagnosed the age of 45 were examined for albumin level by radioimmunoassay. Seventy-six patients with albumin concentrations of 30 to 140 micrograms per milliliter were identified for long-term follow-up. They were compared with normal controls, diabetic patients with lower albumin concentrations (75 patients with concentrations less than 15 micrograms per milliliter and 53 with concentrations of 16 to 29 micrograms per milliliter), and 28 diabetic patients with higher concentrations (greater than 140). Age, duration of diabetes, treatment method, fasting blood glucose level, blood pressure, height, and weight were determined for the four diabetic groups. After nine years the group with albumin concentrations of 30 to 140 micrograms per milliliter was more likely to have clinically detectable proteinuria (greater than 400 micrograms per milliliter) than were the groups with lower concentrations. Mortality was 148 per cent higher in this group than in normal controls--comparable to the increase (116 per cent) in the group with heavy proteinuria (albumin levels greater than 140 micrograms per milliliter). In addition, mortality was increased 76 per cent in the group with albumin levels of 16 to 29 micrograms per milliliter and 37 per cent in the group with levels below 15. We conclude that microalbuminuria in patients with Type II diabetes is predictive of clinical proteinuria and increased mortality.
Insights
Microalbuminuria, a marker in Type II diabetes, predicts future proteinuria and increased mortality. Early detection of microalbuminuria can help identify high-risk diabetic patients for closer monitoring and intervention.
Area of Science:
- Nephrology
- Endocrinology
- Diabetology
Background:
- Type II diabetes is a leading cause of chronic kidney disease.
- Microalbuminuria is an early indicator of diabetic nephropathy.
- Predictive value of microalbuminuria for mortality in Type II diabetes requires further investigation.
Purpose of the Study:
- To determine if microalbuminuria predicts the development of proteinuria.
- To assess the association between microalbuminuria and mortality in Type II diabetics.
- To compare the predictive value of different levels of albuminuria.
Main Methods:
- Radioimmunoassay of morning urine specimens to measure albumin levels.
- Long-term follow-up (9 years) of 76 Type II diabetic patients with microalbuminuria (30-140 µg/mL).
- Comparison with diabetic patients having lower and higher albuminuria levels, and normal controls.
Main Results:
- Patients with microalbuminuria were more likely to develop clinically detectable proteinuria (>400 µg/mL) after 9 years.
- Mortality was 148% higher in the microalbuminuria group compared to normal controls.
- Increased mortality was also observed in diabetic groups with lower albuminuria levels.
Conclusions:
- Microalbuminuria is a significant predictor of clinical proteinuria in Type II diabetes.
- Microalbuminuria is associated with increased mortality in Type II diabetic patients.
- Even lower levels of albuminuria in diabetics are linked to elevated mortality risk.