Microalbuminuria and mortality in long-duration type 1 diabetes.
OBJECTIVE
Microalbuminuria is a recognized risk factor for increased mortality and renal failure in type 1 diabetes. Whether it remains a powerful predictor in patients with a long duration of type 1 diabetes is not known. We ascertained the prognostic significance of abnormal urinary albumin excretion in a cohort of patients with at least 30 years of type 1 diabetes.


METHODS
A total of 190 patients with a disease duration of type 1 diabetes of at least 30 years with baseline and 5 years of follow-up.


RESULTS
At baseline 66% were normoalbuminuric, and at 5 years 11% of this cohort had died. Of the 22% who were microalbuminuric at baseline, 26% had died, and of the 8% with persistent proteinuria at baseline, 44% had died. Of the 4% with end-stage renal failure at baseline, 71% had died within 5 years. Death was attributable to a cardiovascular cause in two-thirds of the cases in all groups.


CONCLUSIONS
Even in those with a long duration of type 1 diabetes, the presence of abnormal urinary excretion remains a powerful predictor of increased mortality.
Allen
Kate V
KV
Department of Diabetes, Royal Infimary, Edinburgh, UK.
Walker
James D
JD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000401:mortality*; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality*; D003928:Diabetic Nephropathies / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors