Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0730345 (microalbuminuria)
 4,018 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Incipient diabetic nephropathy is characterized by a urinary albumin excretion (UAE) between 30-300 mg/24 h and a slightly elevated blood pressure. We measured blood pressure in 14 insulin-dependent diabetic subjects (IDDs) with persistent microalbuminuria (group A) and 50 IDDs with persistent normoalbuminuria (group B) using 3 different methods: 1) Sphygmomanometer, by a nurse, on supine position since 10 min, on the third day of hospitalization; 2) automatic device (Dinamap), on supine position, every 5 min, during 30 min; 3) ambulatory blood pressure (Spacelab 90202 every 15 min between 8 a.m. and 8 p.m.; values obtained with this last method were compared to the mean values of healthy subjects of same age. Recorded UAE was the median value of 3 twenty-four-hours urines. Blood pressure was not different among the two groups with any of the three methods: 1) SBP/DBP A: 136 +/- 14/81 +/- 9 vs B: 131 +/- 13/78 +/- 8 mmHg; ns; 2) SBP/MBP/DBP A: 134 +/- 17/96 +/- 12/79 +/- 10 vs B: 127 +/- 13/90 +/- 10/74 +/- 10 mmHg; ns; 3) A: 132 +/- 12/97 +/- 11/84 +/- 9 vs B: 127 +/- 11/91 +/- 9/82 +/- 12 mmHg; ns. There were no concordance between microalbuminuria/normoalbuminuria and systolic or diastolic blood pressure higher/lower than the mean of the healthy subjects (X2 = 1.6; ns). However, UAE was significantly related to MBP measured with 1): r = 0.29; p = 0.027, but not with 2): r = 0.24; ns, nor with 3): r = 0.26; ns. These results suggest that: 1-blood pressure of IDDs should be measured in standardized conditions; 2-diurnal ambulatory blood pressure recording does not predict incipient nephropathy in these subjects.
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PMID:[Comparison of 3 methods of measurement of blood pressure in insulin-dependent diabetic patients with or without incipient diabetic nephropathy]. 148 51

The purpose of the study was to evaluate the loss of nocturnal (N) decline in blood pressure (BP) in type II treated hypertensive diabetics. The study concerned 36 hypertensive diabetics 59 +/- 10 years old, 20 men and 16 women, with poor metabolic control (HbA1C: 9.6 +/- 3%), without dysautonomia; 14 had macroproteinuria and/or microalbuminuria (mu alb) (< 30 micrograms/min). An ambulatory BP monitoring (Spacelabs 90207) was performed in all patients. Left ventricular mass index (LVMI) and E/A were determined by Doppler-echocardiography. Two groups (G) were individualized: G1 (n = 17), with a normal circadian rhythm (diurnal and N.BP significantly different); G2 (n = 19) with a loss of N decline in systolic (S) and diastolic (D) BP or both; and compared to non diabetic treated hypertensive controls (G3). There was no difference neither in LVMI (125 +/- 43 g/m2), E/A (0.7), 24 h-mean (M) BP in the three groups, nor in HbA1C levels and mu alb occurrence in G1 and G2. Mean N.SBP and mean N.DBP were more closely related to LVMI in G2 than in G1 and G3. [table: see text] Half of these hypertensive diabetics, with bad metabolic control, have an altered circadian BP pattern; the prognostic value of nocturnal BP, related to LVMI despite the antihypertensive treatment, is suggested.
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PMID:[Value of nocturnal blood pressure in treated non-insulin-dependent hypertensive patients]. 148 52

The present study demonstrates the relationship between urinary albumin excretion rate (AER) and renal structural changes in patients with non-insulin-dependent diabetes mellitus (NIDDM) without clinical proteinuria. Resting AER in 30 control subjects and 67 NIDDM patients were 10.4 +/- 4.8 (mean +/- SD) micrograms/min (range 4.3-21.1 micrograms/min) and 26.4 +/- 32.3 micrograms/min (range 0.4-155 micrograms/min), respectively. Persistent normoalbuminuria (less than 20 micrograms/min) and microalbuminuria (20-200 micrograms/min) were found in 43 (Group A) and 24 (Group B) diabetics. There were significant differences in age, diabetes duration, and frequency of retinopathy (background and proliferative) as well as that of proliferative retinopathy between Groups A and B, but not in the other clinical parameters such as body mass index, HbA1, Ccr, or systolic and diastolic blood pressure (SBP, DBP). When compared with 11 normoalbuminuric patients of similar age and equal diabetes duration to those in Group B, the sole difference in clinical parameters was the existence of proliferative retinopathy in Group B. Renal structural changes were investigated by light microscopy in 14 people in Group A and 13 people in Group B, and additionally in 5 NIDDM patients with both macroalbuminuria (greater than or equal to 200 micrograms/min) and normal or nearly normal renal function (Group C). The diffuse glomerular lesion (Gellman's classification) was grade I or II in A, II or III in B, and III in C.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Relationship between urinary albumin excretion rate and renal histology in non-insulin-dependent diabetes mellitus: with reference to the clinical significance of microalbuminuria. 252 62

The aim of this study was to evaluate the relationship between nocturnal blood pressure (BP) (by ambulatory blood pressure monitoring, ABPM) and urinary albumin excretion (UAE) in hypertensive patients with type II diabetes mellitus. We studied 179 essential hypertensives (WHO I-II), all males, with non-insulin-dependent diabetes. Non-invasive ABPM was performed by a fully automatic, portable device (Spacelabs 90202), set to take readings at 15-min intervals during both day-time 7 AM to 1 PM and nighttime (1 PM to 7 AM). According to the day/night reduction in mean blood pressure (MBP), three groups were identified: group I, nocturnal MBP reduction > 10%; group II, day/night MBP reduction of 5% to 10%; and group III, day/night MBP reduction < 5%. The mean values of UAE as well as the prevalence of microalbuminuria (UAE > 30 mg/24 h) were found to be significantly higher in group III as compared to the other two groups. Besides, in group III UAE displayed a significant negative relationship with the SBP and MBP (but not DBP) nocturnal drop and a positive relationship with the duration of hypertension and duration of diabetes. In group II, UAE was weakly correlated only with the duration of hypertension, whereas in group I no significant correlation was found between UAE and other parameters of the study. These results indicate that in hypertensive type II diabetic patients a blunted nocturnal BP fall is associated with higher UAE and increased prevalence of microalbuminuria. Whether the reduced day/night BP difference is the cause of consequence of target organ damage remains to be established.
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PMID:Urinary albumin excretion and nocturnal blood pressure in hypertensive patients with type II diabetes mellitus. 781 39

Ambulatory blood pressure (ABP) was measured every 15 min for 24 h in 82 diabetic subjects aged 35 to 79 years and in 66 healthy controls having the same age and office blood pressure. The autonomic control in diabetic subjects was evaluated by the total score of five cardiovascular function tests (a high score means an autonomic neuropathy). The diurnal cycle of BP was assessed by the difference of BP between daytime and nighttime (delta BP = BP in the day - BP in the night). The variability of BP was evaluated by the standard deviations of the readings. Compared with control subjects, diabetic subjects had the same 24-h mean level of BP, a smaller delta BP, and an increased variability during the daytime; however, the differences were in the limit of statistical significance. Clearcut results were obtained in diabetic subjects with autonomic neuropathy. In the latter, the score of autonomic neuropathy was (1) negatively correlated to delta SBP (systolic) and delta DBP (diastolic) (r = 0.44, P = .0004 and r = 0.46, P = .0004, respectively) and (2) positively correlated to the variability of SBP and DBP during the daytime (r = 0.46, P .0004 and r = 0.29, P = .03, respectively). In diabetic subjects, mean level and variability of ABP were positively correlated to urinary microalbumin. The relationships were the most significant when one relates microalbuminuria to the level of SBP in the night (r = 0.42, P < .0003) and to the variability of SBP in the day (r = 0.32, P = .008).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ambulatory blood pressure in diabetic subjects. 791 44

Ambulatory blood pressure monitoring (ABPM) is currently proposed for measuring blood pressure in type I, insulin-dependent diabetic subjects with incipient diabetic nephropathy. However, the value of this method, in comparison with conventional ones in detecting blood pressure differences between normotensive type I, insulin-dependent diabetic subjects with or without microalbuminuria, is questionable. We obtained systolic, diastolic, and mean blood pressures (SBP/DBP/MBP) in 10 hospitalized normotensive type I, insulin-dependent diabetic subjects with microalbuminuria, and in 29 others without, using a mercury sphygmomanometer (method 1) and an automatic device (Dinamap; method 2) to obtain morning (9 to 11 AM) measurements, and ABPM (SpaceLabs 90207; method 3) to obtain daytime (7 AM to 10 PM) and nighttime (10 PM to 7 AM) measurements. During the daytime, SBP/DBP/MBP values were higher in microalbuminuric than in normoalbuminuric patients, whatever the blood pressure measurement method used (P = .034/.061/.033, two-factor ANOVA). Analysis of 24-h ABPM also showed higher SBP/DBP/MBP in microalbuminuric than in normoalbuminuric patients (P = .022/.040/.016), and demonstrated a defect in nocturnal SBP decrease in microalbuminuric compared with normoalbuminuric patients (P = .028). Stepwise multiple regression analysis indicated nocturnal SBP as the only independent factor determining for microalbuminuria (F = 6.72). Thus ABPM, in relation to other methods, indicates above all that the most relevant blood pressure change in type I insulin-dependent diabetic subjects with microalbuminuria is a defect in nocturnal SBP decrease.
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PMID:Value of ambulatory blood pressure monitoring in type I (insulin-dependent) diabetic patients with incipient diabetic nephropathy. 800 72

The aim of this study was to evaluate the action of trandolapril on blood glucose control and microalbuminuria in mild to moderate hypertensive in patients with non-insulin-dependent diabetes. Sixty-seven patients, aged between 33 and 79, were enrolled. After a two week placebo run-in period, treatment with trandolapril as monotherapy was given for 3 months. The dose of trandolapril was adjusted between 1 and 4 mg/day according to antihypertensive response. Patients were assessed clinically and by laboratory investigations each month. Two patients were excluded from efficacy analysis because of major protocol deviations. Mean DBP fell, under the influence of treatment, from 101 +/- 5 mmHg to 82 +/- 7 mmHg (p < 0.0001) and mean SBP from 171 +/- 9 mmHg tp 147 +/- 11 mmHG (p < 0.0001). At three months, 54 patients (84%) had a DBP < or = 90 mmHg. Microalbuminuria decreased significantly (p = 0.03) during treatment. Microalbuminuria returned to normal in 11 of the 13 patients in whom the baseline value was above 21 micrograms/min and increased to above normal in 2 of the 26 patients who had a normal baseline value. Blood glycosylated hemoglobin, fructosamine, glucose and creatinine, and creatinine clearance remained stable. Plasma potassium rose slightly in 7 patients. Six adverse events were reported (4 coughs, 1 peripheral edema, 1 plantar mal perforans). One patient died from pulmonary embolism. In conclusion, trandolapril is an effective antihypertensive agent in hypertensive diabetics. Trandolapril causes a significant decrease in microalbuminuria and does not interfere with blood glucose control in these patients.
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PMID:[Action of trandolapril on the blood glucose balance and microalbuminuria in hypertensive diabetics]. 817 83

The aim of this study is to elucidate the clinical significance of estimating renal size in non-insulin-dependent diabetes mellitus (NIDDM). Renal size was compared in 57 NIDDM patients with persistent normoalbuminuria [group I; 19 cases, albumin excretion rate (AER) < 20 micrograms/min], microalbuminuria (group II; 24 cases, AER = 20-200 micrograms/min), or macroalbuminuria (group III; 14 cases, AER > 200 micrograms/min). Three groups were matched for age and diabetes duration. Renal size was estimated using drip-infusion pyelography according to Simon's method (mean kidney length/height of second lumbar spine and disc; renal ratio, RR). Thirteen patients with persistent microalbuminuria (10 normotensive and 3 hypertensive) were traced during at least 3 years. Angiotensin-converting enzyme inhibitor (enalapril) was used in 11 cases. The results are as follows: (1) Renal size in groups II (RR, 3.47 +/- 0.28; cited as mean +/- SD) and III (3.62 +/- 0.32) significantly increased compared with that in group I (3.26 +/- 0.20) (p < 0.01 and p < 0.001, respectively). No statistical differences could be detected between groups II and III. (2) As a whole, good metabolic (glycosylated hemoglobin, HbA1) and hemodynamic (systolic blood pressure, SBP) control was achieved during the last 12 months (HbA1, 8.4% +/- 0.9%; SBP, 122 +/- 8 mm Hg). There was no significant correlation between RR and creatinine clearance, HbA1, SBP, or diastolic blood pressure during the first and last 12 months. Initial RR significantly correlated with AER during the last 12 months (r = 0.651, p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal hypertrophy as a prognostic index for the progression of diabetic renal disease in non-insulin-dependent diabetes mellitus. 848 47

Extensive ablation of renal mass in experimental animals leads to progressive glomerulosclerosis and chronic renal failure (CRF). Clinical studies are far from answering the question whether patients with reduced renal mass are at risk of developing progressive CRF. The aim of our study was to examine the morphological and functional aspects of the remnant kidney in a group of patients who underwent unilateral nephrectomy for renal tuberculosis: 313 patients (161 M, 152 F) mean age 57.2 +/- 10.7, were examined after a period ranging from 13.56 to 591.2 months. All patients were on ad libitum diet. Hypertension was found in 34.19% of the patients; SBP was 155.29 +/- 19.9 mmHg and DBP was 92.74 +/- 13.07 mmHg. Estimation of renal size performed by ultrasound scanner gave the following results: length 116.78 +/- 8.99 mm; width 58.24 +/- 7.21 mm; thickness 17.88 +/- 1.96 mm. Kidney function assessed by serum creatinine levels showed a mean level of 1.28 +/- 0.53 mg%. Forty-two patients (13.41%) had serum levels > 1.5 mg% but 18 of them had nonconcomitant systemic or renal involvement. Microalbuminuria determined by RIA assay was found in 50.5% of the patients. In our group of patients renal functional impairment was low and hyperfiltration expressed as microalbuminuria does not appear to be a primary factor in the progression of renal failure.
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PMID:Unilateral nephrectomy and progression of renal failure. 851

We studied 24-h ambulatory systolic and diastolic blood pressure (SBP, DBP), 16-h daytime and 8-h nighttime urinary excretion of albumin (UAE) and retinol-binding protein (URBP) in 20 type 1 diabetic patients (group 1) with normoalbuminuria (UAE < 20 micrograms/min) and 20 type 1 diabetic patients (group 2) with microalbuminuria and low proteinuria (UAE 20-500 micrograms/min). The groups were comparable in age, diabetes duration and actual glycaemic control. Daytime and nighttime SBP and DBP were higher in group 2 compared to group 1 (p < 0.01). Nighttime decrease in SBP and DBP correlated with nighttime decrease in UAE in group 2 (p < 0.05, p < 0.001). There was no correlation between BP and actual glycemic control in either group. Daytime UAE was found in group 2 by 20% higher than nighttime UAE. We found higher daytime and nighttime URBP in group 2 compared to group 1 (p < 0.05). We conclude, that microalbuminuric and low-proteinuric patients had elevated BP and nighttime decrease in BP correlated with nighttime decrease in UAE but not with actual glycemic control. Increased URBP in these patients suggests impaired proximal renal tubular function in early stages of diabetic nephropathy.
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PMID:[Diurnal changes in blood pressure, albuminuria and urinary excretion of retinol-binding protein in type I diabetics]. 862 57


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