Document Detail


Risk markers of future microalbuminuria and hypertension based on clinical and morphological parameters in young type 1 diabetes patients.
MedLine Citation:
PMID:  19761528     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Nephropathy is a severe complication of type 1 diabetes and develops in 30% of patients. Currently, it is not possible to identify young patients at risk prior to the development of microalbuminuria (MA) and/or hypertension (HT). OBJECTIVE: To study predictors of MA and/or HT in young normoalbuminuric (NA) patients with type 1 diabetes. SUBJECTS AND Methods: Forty-six NA and normotensive (NT) type 1 diabetes patients, regularly followed since onset with checks on metabolic control, kidney function, and MA, were investigated with kidney biopsies and 24-h ambulatory blood pressure measurements (ABPMs) after 10.6 yr of diabetes. The patients were followed another six and a half years with regard to the development of MA and HT. RESULTS: Fifteen patients developed MA and/or HT during follow-up. The strongest risk markers were poor metabolic control after puberty, high day-time systolic blood pressure (BP), and increased BMT at 10 yr, which explained 62% of the outcome for MA and/or HT at 17 yr duration with 77% sensitivity and 65% specificity. The threshold values were long-term postpubertal HbA(1c) > 8.2%, day-time systolic BP > 130 mmHg, and BMT > 490 nm/1.73 m(2). CONCLUSIONS: Normoalbuminuric and NT patients at risk of developing MA and HT could be identified and might benefit from an early start of antihypertensive therapy and improvement of metabolic control.
Authors:
Nina E S S Perrin; T Torbjörnsdotter; Georg A Jaremko; Ulla B Berg
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric diabetes     Volume:  11     ISSN:  1399-5448     ISO Abbreviation:  Pediatr Diabetes     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-21     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100939345     Medline TA:  Pediatr Diabetes     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  305-13     Citation Subset:  IM    
Affiliation:
Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Children's Hospital, Karolinska University Hospital, Stockholm, Sweden. Nina.Perrin@karolinska.se
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Albuminuria / diagnosis*,  etiology
Biological Markers / blood
Blood Pressure Monitoring, Ambulatory
Child
Diabetes Mellitus, Type 1 / complications*,  pathology,  physiopathology
Diabetic Nephropathies / diagnosis*,  etiology
Follow-Up Studies
Hemoglobin A, Glycosylated / analysis
Humans
Hypertension / diagnosis*,  etiology
Kidney / physiopathology
Middle Aged
Risk Factors
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human

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