title: [What values should be used to diagnose microalbuminuria in patients with diabetes mellitus?].
abstract: Diabetic nephropathy (DN) is a complication of diabetes mellitus (DM) associated with increased morbi-mortality. The identification of individuals at high risk for DN will make its prevention more effective. Urinary albumin excretion rate (UAER) is still the best marker for DN development and progression. It is also a major risk factor for macrovascular disease. High-normal albuminuria (< 20 microg/min) is still associated with development of micro- and macroalbuminuria. UAER has a continuous relationship with the development of renal and cardiovascular disease, without a cutoff point from which there is a highly increased risk. However, in clinical practice we need a reference value in order to guide the patient's treatment. Some evidence indicates values of UAER between 5 and 10 microg/min as a new cutoff point for the diagnosis of microalbuminuria. In conclusion, the association between UAER and the renal and cardiovascular outcomes seems to be continuous and is already present with UAER within the normal range. The adoption of a UAER value around 5 to 10 microg/min as risky could identify patients that should receive earlier and more aggressive treatment of modifiable risk factors.
authors.affiliation: Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do SulRS.
authors.forename: Cristiane B
authors.initials: CB
authors.lastname: Leitão
authors.forename: Luís Henrique
authors.initials: LH
authors.lastname: Canani
authors.forename: Patrícia B
authors.initials: PB
authors.lastname: Bolson
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Molon
authors.forename: Sandra Pinho
authors.initials: SP
authors.lastname: Silveiro
authors.forename: Jorge Luiz
authors.initials: JL
authors.lastname: Gross
mesh_terms: D000418:Albumins / Q000032:analysis*; D000419:Albuminuria / Q000175:diagnosis* / Q000209:etiology / Q000652:urine; D015415:Biomarkers; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology*; D003404:Creatinine / Q000652:urine; D003928:Diabetic Nephropathies / Q000209:etiology* / Q000652:urine; D006801:Humans
chemical_list: D000418:Albumins; D015415:Biomarkers; D003404:Creatinine