Document Detail


Progression of borderline increases in albuminuria in adolescents with insulin-dependent diabetes mellitus.
MedLine Citation:
PMID:  9300227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We aimed to determine the natural history of borderline increases in albuminuria in adolescents with insulin-dependent (Type 1) diabetes mellitus (IDDM) and factors which are associated with progression to persistent microalbuminura. Fifty-five normotensive adolescents with IDDM and intermittent microalbuminura (overnight albumin excretion ratte of 20-200 micrograms min-1 on one of three consecutive timed collections, n = 29) or borderline albuminura (mean overnight albumin excretion rate of 7.2-20 micrograms min-1 on one of three consecutive timed collections, n = 30) were followed prospectively at 3 monthly intervals. The endpoint was persistent microalbuminuria defined as a minimum of three of four consecutive overnight albumin excretion rates of greater than 20 micrograms min-1. One hundred and forty-two adolescents with IDDM and normoalbuminura were also followed prospectively. Fifteen of the 59 patients (25.4%) with intermittent (9/29) or borderline (6/30) albuminura progressed to persistent microalbuminura (progressors) over 28 (15-50) months [median (range)] in comparison with two of the 142 patients with normoalbuminuria at entry (relative risk = 12.6; p = 0.001). Progressors to persistent microalbuminura were pubertal and had higher systolic (p = 0.02) and diastolic (p = 0.02) blood pressure, and HbA1c (p = 0.004) than non-progressors. All patients remained normotensive. Glomerular filtration rate, apolipoproteins, dietary phosphorus, protein and sodium intakes, and prevalence of smoking did not differ between progressors and non-progressors. Total renin was higher in the diabetic patients without a difference between progressors and non-progressors. In conclusion there is a relatively high rate of progression to persistent microalbuminuria in pubertal adolescents with borderline increases in albuminura and duration greater than 3 years. These patients require attention to minimize associated factors of poor metabolic control and higher blood pressure in the development of incipient nephropathy.
Authors:
J J Couper; C F Clarke; G C Byrne; T W Jones; K C Donaghue; J Nairn; D Boyce; M Russell; M Stephens; J Raymond; D J Bates; K McCaul
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  14     ISSN:  0742-3071     ISO Abbreviation:  Diabet. Med.     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1998-01-02     Completed Date:  1998-01-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  766-71     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, Women's and Children's Hospital, Adelaide, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Albuminuria / diagnosis,  etiology*,  physiopathology
Blood Pressure / physiology*
Child
Diabetes Mellitus, Type 1 / complications*,  physiopathology
Diabetic Nephropathies / diagnosis,  etiology*,  physiopathology
Disease Progression
Female
Follow-Up Studies
Hemoglobin A, Glycosylated / analysis*,  metabolism
Humans
Male
Prospective Studies
Serum Albumin / metabolism*
Time Factors
Chemical
Reg. No./Substance:
0/Hemoglobin A, Glycosylated; 0/Serum Albumin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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