[Is microalbuminuria, an early marker of clinical nephropathy, also a cardiovascular risk factor?].
Microalbuminuria is not only a predictor of diabetic nephropathy in type 1 diabetes, but also a potent marker of cardiovascular risk, especially in type 2 diabetes. Microalbuminuria also predicts cardiovascular morbidity in the general population. We describe semi-quantitative and quantitative methods for determination of low urinary excretion of albumin. Pathogenetic hypotheses common to both renal and endothelial dysfunction are discussed, suggesting that microalbuminuria may be a link between micro- and macroangiopathy. Improved glycemic control and antihypertensive treatment postpone and potentially prevent development of nephropathy in diabetic patients with microalbuminuria. These interventions must be instituted early in the development of diabetic nephropathy. In type 2 diabetes, prospective studies are needed to evaluate the precise impact of such a therapy on the cardiovascular risk.
Raynaud
E
E
Unité d'exploration métabolique, Centre hospitalier universitaire, Hôpital Lapeyronie, Montpellier.
Brun
J F
JF
Fédou
C
C
Puech-Cathala
A M
AM
Pérez-Martin
A
A
Orsetti
A
A
D000419:Albuminuria / Q000150:complications*; D000818:Animals; D015415:Biomarkers; D002318:Cardiovascular Diseases / Q000209:etiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000235:genetics; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000235:genetics; D003928:Diabetic Nephropathies / Q000209:etiology*; D020022:Genetic Predisposition to Disease; D006801:Humans; D012307:Risk Factors
D015415:Biomarkers
La micro-albuminurie, marqueur précoce d'atteinte rénale, est-elle aussi un facteur de risque cardiovasculaire?