A story of microalbuminuria and diabetic nephropathy.
BACKGROUND
It is estimated that more than 346 million people worldwide have diabetes mellitus . By the year 2030, it is predicted that diabetes will become the seventh leading cause of death in the world. Development of chronic kidney disease (CKD) in patients with diabetes adds significantly to the morbidity and mortality and significantly increases health care costs, even before the development of end stage renal disease (ESRD). Evidence  acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO) and Web of Science have been searched.


RESULTS
Diabetic nephropathy (DN) is increasing rapidly worldwide. It is the leading cause of new cases of ESRD in the USA.  Interestingly, although DN is the most common cause of ESRD in diabetic patients, diabetes mellitus is also an independent and strong risk factor for ESRD ascribed to causes other than DN (e.g. hypertensive nephropathy).


CONCLUSIONS
It is important to be aware of the pitfalls of using the urine albumin level in predicting development and progression of diabetic nephropathy in order to treat and advise the patients accurately.  Research into finding new markers is rapidly evolving but current progress makes it likely we will be using the urine albumin level for some years into the future.
Division of Renal Diseases and Hypertension, University of Colorado Denver, 12700 East 19th Ave. Room 7015Aurora, CO 80045, USA.
Bijan
B
Roshan
Joslin Diabetes Center and Harvard Medical School, One Joslin Place, Renal Division. Boston, MA 02215, USA.
Robert C
RC
Stanton
Chronic kidney disease; Diabetic nephropathy; Microalbuminuria