Document Detail


Time to abandon microalbuminuria?
MedLine Citation:
PMID:  16871239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The term microalbuminuria--a urinary albumin excretion (UAE) between 20 and 200 microg/min--has been introduced to identify subjects at increased risk of renal and cardiovascular disease. However, the relationship between albuminuria and risk is not restricted to the microalbuminuric range and extends to as low as 2-5 microg/min. On the contrary, the increase of UAE above 200 microg/min (macroalbuminuria) heralds the onset of proteinuria (urinary protein excretion above 0.5 g/24 h) and progressive renal and cardiovascular disease. Albuminuria is a component of the metabolic syndrome and may represent a marker of the increased risk of renal and cardiovascular disease associated with insulin resistance and endothelial dysfunction. Proteinuria is a sign of established kidney damage and plays a direct pathogenic role in the progression of renal and cardiovascular disease. Albuminuria reflects functional and potentially reversible abnormalities initiated by glomerular hyperfiltration, proteinuria, a size-selective dysfunction of the glomerular barrier normally associated with glomerular filtration rate (GFR) decline that may result in end-stage renal disease. Thus, the limit of 200 microg/min segregates patients with albuminuria or proteinuria who are at quite different risk. Among subjects with albuminuria, however, there is a continuous relationship between albumin excretion and risk and no lower bound between normal albuminuria and microalbuminuria can be identified that segregates subjects at different risk. Thus, the terms microalbuminuria and macroalbuminuria could be replaced by the concepts of albuminuria- and proteinuria-associated diseases. Future studies are needed to identify levels of albuminuria below which therapy is no longer beneficial.
Authors:
P Ruggenenti; G Remuzzi
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Publication Detail:
Type:  Comparative Study; Journal Article; Review     Date:  2006-07-26
Journal Detail:
Title:  Kidney international     Volume:  70     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-21     Completed Date:  2006-11-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1214-22     Citation Subset:  IM    
Affiliation:
Clinical Research Centre for Rare Diseases 'Aldo e Cele Daccò', Mario Negri Institute for Pharmacological Research, Villa Camozzi, Ranica, Bergamo, Italy.
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MeSH Terms
Descriptor/Qualifier:
Albuminuria* / complications,  diagnosis,  etiology
Angiotensin-Converting Enzyme Inhibitors / administration & dosage,  therapeutic use
Animals
Antihypertensive Agents / administration & dosage,  therapeutic use
Biological Markers
Cardiovascular Diseases / epidemiology,  prevention & control*
Chronic Disease
Cross-Sectional Studies
Diabetes Mellitus, Type 2 / complications
Disease Progression
Endothelium, Vascular / physiopathology
Forecasting
Glomerular Filtration Rate
Humans
Insulin Resistance
Kidney Diseases / epidemiology,  prevention & control*
Kidney Failure, Chronic / etiology,  prevention & control
Losartan / administration & dosage,  therapeutic use
Metabolic Syndrome X / complications,  urine
Polycystic Kidney, Autosomal Dominant / epidemiology,  prevention & control
Proteinuria / complications,  diagnosis,  etiology
Randomized Controlled Trials as Topic
Rats
Risk Factors
Terminology as Topic*
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Biological Markers; 114798-26-4/Losartan

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


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