Assessment of Risk of Overt Nephropathy in Diabetic Patients From Albumin Excretion in Untimed Urine Specimens

Nelson, Robert G.; Knowler, William C.; Pettitt, David J.; Saad, Mohammed F.; Charles, Marie Aline; Bennett, Peter H.

doi:10.1001/archinte.1991.00400090057011

Cited by 80 publications

(41 citation statements)

References 36 publications

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“…An albumin-to-creatinine ratio between 30 and 299 mg/g was defined as microalbuminuria and a level у300 mg/g as proteinuria in accordance with previous publications. 13,14 Obesity was defined by a BMI у30 kg/m 2 . 15 Waist circumference and waist-to-hip ratio more than or equal to the 80th gender-specific percentiles of the analysis population were used to define elevated waist circumference and central adiposity.…”

Section: Methodsmentioning

confidence: 99%

Microalbuminuria, central adiposity and hypertension in the non-diabetic urban population of the MONICA Augsburg survey 1994/95

Liese

Hense

Döring³

et al. 2001

J Hum Hypertens

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Objective: Microalbuminuria is a renal marker of general vascular endothelial damage and early atherosclerosis with adverse prognostic implications. Microalbuminuria is associated with diabetes, insulin resistance, central adiposity and hypertension. We evaluated the degree of the association of components of the metabolic syndrome with microalbuminuria in a subsample of a nondiabetic study population. Design: Men and women aged 25-74 living in the city of Augsburg, Germany, were interviewed and examined in a standardised manner at a population-based survey conducted in 1994/95. Persons with a history of diabetes or HbA1c level у7% were excluded. Outcome: Albumin and creatinine were determined quantitatively in a spot urine and defined as microalbuminuria via an albumin/creatinine ratio between 30 and 299 mg/g. Results: Among 920 men and 879 women, the agestandardised prevalence of microalbuminuria was 8.0%

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Section: Methodsmentioning

confidence: 99%

Microalbuminuria, central adiposity and hypertension in the non-diabetic urban population of the MONICA Augsburg survey 1994/95

Liese

Hense

Döring³

et al. 2001

J Hum Hypertens

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“…The latter seems to be true in nondiabetic subjects as well (8,9). UAE is most conveniently assessed in diabetic and nondiabetic subjects by the albuminto-creatinine ratio (ACR) in random urine specimens (10)(11)(12)(13).…”

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confidence: 99%

Segregation analysis of urinary albumin excretion in families with type 2 diabetes.

et al. 2000

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Elevated urinary albumin excretion (UAE) is a predictor of the development of nephropathy and cardiovascular mortality. To study whether genetic factors may determine UAE, we examined familial aggregation of UAE in 96 large multigenerational pedigrees ascertained for type 2 diabetes. A total of 1,269 subjects had UAE measured as the urinary albumin-to-creatinine ratio (ACR). This included 630 subjects with type 2 diabetes and 639 subjects without diabetes. A significant correlation (Spearman's correlation 0.34, P < 0.001) was found between the median ACR values determined separately in nondiabetic and diabetic members of the same family. To determine whether this familial aggregation of ACR could be explained by the transmission of 1 or more major genes and thus be suitable for gene mapping studies, segregation analyses were performed. In these analyses, ACR was modeled as a continuous trait with the inclusion of age, sex, and duration of diabetes as covariates. Likelihood ratio tests were performed to test competing hypotheses, and Akaike's information criterion was used to determine the most parsimonious models. The Mendelian model with multifactorial inheritance was supported more strongly than Mendelian inheritance alone. These analyses suggested that the best model for ACR levels was multifactorial with evidence for a common major gene. When the analyses were repeated for diabetic subjects only, the evidence for Mendelian inheritance was improved, although a single major locus with additional multifactorial effects was more strongly supported. The results from the current study suggest that levels of UAE are determined by a mixture of genes with large and small effects as well as other measured covariates, such as diabetes.

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“…The National Kidney Foundation note that increased excretion of albumin is a sensitive marker for chronic kidney disease because of diabetes, hypertension, or glomerular disease, 21 with microalbuminuria progressing to overt proteinuria in 20% to 40% of patients with type 2 diabetes. 8,22 Although data in elderly hypertensive patients with type 2 diabetes are limited, the Systolic Hypertension in the Elderly Program (SHEP) and the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) included large elderly diabetic populations. The SHEP study included only patients with isolated systolic hypertension (ISH); however, JNC 7 notes that by age 60 years, about two thirds of individuals with hypertension have ISH 20 ; hence a large proportion of patients in the NESTOR elderly population are likely to have had this diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…6 Microalbuminuria is recognized as a strong and early predictor for the development of diabetic renal diseases (including end-stage renal disease), 7,8 and is itself associated with an increased risk of morbidity and mortality from cardiovascular disease. 9 The angiotensin-converting enzyme inhibitors (ACEI) are known to decrease proteinuria and to preserve glomerular filtration rate (GFR) in patients with diabetes, 10,11 but little is known about the effects of diuretic therapy on microalbuminuria in diabetic patients.…”

mentioning

confidence: 99%

Efficacy of Indapamide SR Compared With Enalapril in Elderly Hypertensive Patients With Type 2 Diabetes

Puig

Marre

Kokot³

et al. 2007

American Journal of Hypertension

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Background: Blood pressure control is the main influential variable in reducing microalbuminuria in patients with type 2 diabetes. In this subanalysis of the Natrilix SR versus Enalapril Study in hypertensive Type 2 diabetics with micrOalbuminuRia (NESTOR) study, we have compared the effectiveness of indapamide sustained release (SR) and enalapril in reducing blood pressure and microalbuminuria in patients ≥65 years of age.

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Assessment of Risk of Overt Nephropathy in Diabetic Patients From Albumin Excretion in Untimed Urine Specimens

Cited by 80 publications

References 36 publications

Microalbuminuria, central adiposity and hypertension in the non-diabetic urban population of the MONICA Augsburg survey 1994/95

Microalbuminuria, central adiposity and hypertension in the non-diabetic urban population of the MONICA Augsburg survey 1994/95

Segregation analysis of urinary albumin excretion in families with type 2 diabetes.

Efficacy of Indapamide SR Compared With Enalapril in Elderly Hypertensive Patients With Type 2 Diabetes

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