Rate of progression of albuminuria in type II diabetes. Five-year prospective study from south India.
OBJECTIVE
To evaluate the potential risk factors for the progression of albuminuria in type II diabetes.


METHODS
A cohort of 481 type II diabetic patients were followed prospectively for 5 years. Blood glucose (BG) and blood pressure (BP) were checked at 2 monthly intervals, and urinary albumin excretion (UAE) was checked at yearly intervals. Progression of albuminuria was recognized by the development of microalbuminuria and macroalbuminuria and a significant increase in albuminuria within the microalbuminuric range.


RESULTS
UAE was normal in 349 patients, 93 patients were microalbuminuric, and the rest (39) were macroalbuminuric. Sixty-two patients with normal UAE developed microalbuminuria. Ten patients with normoalbuminuria and 23 with microalbuminuria developed macroalbuminuria during the 5-year observation period with overall incidence of 46.9/1,000 person-years for normoalbuminuria and 58.7/1,000 person-years for microalbuminuria. Baseline UAE was significantly higher in those patients who progressed compared with those patients who did not (normoalbuminuria: 8.5 +/- 6 vs. 5.3 +/- 4 micrograms/min, P < 0.001; microalbuminuria: 68.5 +/- 57 vs. 47.4 +/- 34 micrograms/min, P < 0.01). Multiple regression analysis revealed initial UAE and diabetes duration to be predictors of albuminuria progression.


CONCLUSIONS
Initial UAE is a strong predictor of albuminuria progression in type II diabetic patients.
Department of Medicine, Biostatistics and Clinical Biochemistry, Christian Medical College and Hospital, Vellore, India.
L
L
John
P S
PS
Rao
A S
AS
Kanagasabapathy
D000419:Albuminuria; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D001786:Blood Glucose; D003404:Creatinine