Microalbuminuria Is Common in Japanese Type 2 Diabetic Patients

Yokoyama, Hiroyuki; Kawai, Koichi; Kobayashi, Masashi

doi:10.2337/dc06-1859

Cited by 62 publications

(35 citation statements)

References 21 publications

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“…According to the Japanese Diabetes Clinical Management (JDDM) Study, the prevalence values of microalbuminuria and macroalbuminuria (31.6% and 10.5%, respectively) [20] were similar to those in the present study (31.4% and 9.3%, respectively). Fifth, sample size in the present study might not be large enough to clearly show the association between high BNP and advanced CKD among patients with type 2 diabetes mellitus.…”

Section: Disclosuresupporting

confidence: 65%

B-type natriuretic peptide and renal function in Japanese patients with type 2 diabetes mellitus: The Dogo Study

et al. 2017

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THE LEADING CAUSE OF THE DEATH among patients with renal dysfunction is cardiovascular diseases [1], and the importance of the interaction between the heart and kidneys is widely note [2]. Plasma B-type natriuretic peptide (BNP) releases from the ventricles in response to hemodynamic stress, and BNP is one of the predictive markers for cardiovascular events [3,4].Among patients with type 2 diabetes mellitus, sev- Abstract. Among patients with type 2 diabetes mellitus, the association between B-type natriuretic peptide (BNP) and renal function remains controversial. We therefore investigated this issue among Japanese patients with type 2 diabetes mellitus. This study included 687 Japanese patients with type 2 diabetes mellitus. BNP levels were divided at quartile points on the basis of the distribution. We used four outcomes regarding the renal function: 1) chronic kidney disease (CKD): estimated glomerular filtration rate (eGFR) < 60mL/min/1.72m 2 , 2) advanced CKD: eGFR < 30mL/min/1.72m 2 , 3) microalbuminuria: urinary albumin creatinine ratio (UACR) ≥ 30 mg/g creatinine, and 4) macroalbuminuria: UACR ≥ 300 mg/g creatinine. The prevalence values of CKD, advanced CKD, microalbuminuria, and macroalbuminuria were 27.4, 2.5%, 31.4%, and 9.3%, respectively. Highest BNP (≥ 39.2 ng/mL) was independently positively associated with microalbuminuria and macroalbuminuria (adjusted ORs, 2.61 [95% CI: 1.53-4.49] and 3.45 [95% CI: 1.46-8.72], respectively). High BNP was not associated with advanced CKD or CKD. There was a statistically significant positive exposure-response relationships between the BNP level and advanced CKD, microalbuminuria, and macroalbuminuria (p for trend = 0.047, 0.001, and 0.003, respectively). BNP level may be independently positively associated with advanced CKD, microalbuminuria, and macroalbuminuria but not CKD in Japanese patients with type 2 diabetes mellitus.

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Section: Disclosuresupporting

confidence: 65%

B-type natriuretic peptide and renal function in Japanese patients with type 2 diabetes mellitus: The Dogo Study

et al. 2017

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“…One possible explanation may be due to the differences in the patient characteristics. In our study, the prevalence of patients with microalbuminuria was nearly equal to that in the population-based study in Japan, 30 but smaller than that of the study by Uzu et al 18 In addition, patients in this study were older, probably explaining the higher prevalence of SCI because aging is a strong predictor of SCI. 8 Further large prospective studies are needed to elucidate the association between SCI and incident albuminuria in diabetic patients.…”

Section: Discussioncontrasting

confidence: 42%

Silent cerebral infarction is associated with the development and progression of nephropathy in patients with type 2 diabetes

et al. 2010

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Chronic kidney disease (CKD) is an important risk factor for cardiovascular disease in patients with diabetes. The relationship between renal manifestations of CKD (albuminuria and decreased glomerular filtration rate) and silent cerebral infarction (SCI) has attracted attention; however, most studies examined the effects of components of CKD on prevalence of SCI. We sought to assess the relationship between SCI and the development and progression of nephropathy in type 2 diabetic patients. We studied 366 type 2 diabetic patients with normoalbuminuria (urinary albumin-to-creatinine ratio [ACR] o30 mg g -1 , N¼246) or microalbuminuria (ACR¼30-299 mg g -1 , N¼120). SCI was defined by cranial MRI. The primary end point was progression from normo-to microalbuminuria or from micro-to macroalbuminuria. The cumulative incidence of the primary end point was estimated using the Kaplan-Meier method. Risk estimates for reaching the end point were calculated using Cox proportional hazard model analyses. During a median follow-up period of 3.9 years, 23 normoalbuminuric and 24 microalbuminuric patients reached the primary end point. Patients with SCI (N¼171) had a greater incidence of reaching the end point than those without SCI (N¼195, P¼0.020 by the log-rank test), with a hazard ratio of 2.02 (95% confidence interval¼1.09-3.72, P¼0.025) in the multivariate Cox regression model. Although the common pathogenesis of SCI and albuminuria in diabetic patients is still unclear, SCI may be a predictor of progression of nephropathy in type 2 diabetic patients.

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“…In fact, the percentage of diabetic patients with normoalbuminuria and low eGFR is supposed to be relatively common in clinical settings. In this aspect, Yokoyama et al [17] described that the proportion of subjects with low eGFR (\60 ml/min per 1.73 m 2 ) and normoalbuminuria was 11.4 % of type 2 diabetic patients examined (262/2,298). Supporting our notion, Rigalleau et al [18] reported that risk for renal progression in such patients with type 1 or type 2 diabetes is lower.…”

Section: \0001mentioning

confidence: 99%

Clinical impact of albuminuria and glomerular filtration rate on renal and cardiovascular events, and all-cause mortality in Japanese patients with type 2 diabetes

et al. 2013

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Background The number of patients suffering from diabetic nephropathy resulting in end-stage kidney disease is increasing worldwide. In clinical settings, there are limited data regarding the impact of the urinary albumin-to-creatinine ratio (UACR) and reduced estimated glomerular filtration rate (eGFR) on renal and cardiovascular outcomes and all-cause mortality. Methods We performed a historical cohort study of 4328 Japanese participants with type 2 diabetes from 10 centers. Risks for renal events (requirement for dialysis or transplantation, or half reduction in eGFR), cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke), and all-cause mortality were assessed according to UACR and eGFR levels. Results During follow-up (median 7.0 years, interquartile range 3.0-8.0 years), 419 renal events, 605 cardiovascular events and 236 deaths occurred. The UACR levels increased the risk and the adjusted hazard ratios for these three events. In addition to the effects of UACR levels, eGFR stages significantly increased the adjusted hazard ratios for renal events and all-cause mortality, especially in 123Clin Exp Nephrol DOI 10.1007/s10157-013-0879-4 patients with macroalbuminuria. Diabetic nephropathy score, based on the prognostic factors, well predicted incidence rates per 1000 patient/year for each event.Conclusions Increased UACR levels were closely related to the increase in risks for renal, cardiovascular events and all-cause mortality in Japanese patients with type 2 diabetes, whereas the association between high levels of UACR and reduced eGFR was a strong predictor for renal events.

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Microalbuminuria Is Common in Japanese Type 2 Diabetic Patients

Cited by 62 publications

References 21 publications

B-type natriuretic peptide and renal function in Japanese patients with type 2 diabetes mellitus: The Dogo Study

B-type natriuretic peptide and renal function in Japanese patients with type 2 diabetes mellitus: The Dogo Study

Silent cerebral infarction is associated with the development and progression of nephropathy in patients with type 2 diabetes

Clinical impact of albuminuria and glomerular filtration rate on renal and cardiovascular events, and all-cause mortality in Japanese patients with type 2 diabetes

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