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Query: UMLS:C0730345 (microalbuminuria)
 4,018 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three hospital sites evaluated the Bayer two-pad urine dipstick as a screening test for microalbuminuria. One pad estimates albumin concentrations between 10 and 150 mg/L, and the second estimates creatinine values between 300 and 3,000 mg/L. The Boehringer Mannheim (BMD) Micral dipstick was also compared and evaluated. The accuracy of the dipsticks was judged by comparison with cuvet-based immunonephelometry for albumin and to standard rate-Jaffe methods for creatinine; these assays were well standardized and controlled and were assumed to give accurate values. Precision of these methods and that of the dipsticks was determined by multiple assays of control materials. Visual or instrument (Clinitek 50 or 100) evaluation of the Bayer or visual checks of the BMD albumin dipstick pad with patients' urines gave clinically acceptable accuracy. The albumin/creatinine ratio from the Bayer dipsticks gave better accuracy for albumin excretion than the albumin pads alone from either manufacturer. This ratio should permit making a good estimate of the 24-hr albumin excretion in a randomly collected urine.
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PMID:Comparison of instrument-read dipsticks for albumin and creatinine in urine with visual results and quantitative methods. 977 58

Diabetic nephropathy remains a leading cause of end-stage renal disease (ESRD) in western societies, accounting for over one-third of all patients beginning renal replacement therapy. Patients with Type 2 diabetes comprise the largest and fastest-growing single disease group requiring renal support therapy. In addition to the high risk of progression to ESRD, diabetic nephropathy is associated with a very high risk of cardiovascular morbidity and mortality, which is not abolished by dialysis and renal transplantation. While the prognosis of patients with diabetic nephropathy has considerably improved, a greater focus has recently been placed on treating diabetic patients early in order to prevent future organ failure. Microalbuminuria is an important intermediary end-point that correlates strongly with future advanced renal disease and cardiovascular mortality. Recent evidence indicates that optimum glycaemic control, tight blood pressure control, and the regular screening for and early treatment of microalbuminuria are necessary to prevent the development and progression of diabetic renal disease. By utilizing such strategies, the challenge is to reduce the cumulative incidence of overt nephropathy, with its associated increase in cardiovascular mortality, and the requirement for renal support therapy. Over the next 5-10 years, the patient with Type 2 diabetes will need to be the specific focus of such preventive treatment modalities.
Baillieres Best Pract Res Clin Endocrinol Metab 1999 Jul
PMID:Diabetic nephropathy. 1076 65

Studies investigating the effect of leptin on bone mass were inconsistent and some related it to the effect of insulin. We intend in this cross-sectional study to investigate the effect of leptin on bone mass in type 1 diabetic patients. We recruited 42 patients with type 1 diabetes for which we determined weight, height, HbA1c, microalbuminuria, serum leptin, bone mineral content (BMC) and density (BMD), and body composition. The patients had an average age of 20.1 +/- 0.6 years, an average body mass index (BMI) of 23.6 +/- 0.5 kg/cm(2) and an average duration of diabetes of 9.1 +/- 1.0 years. The Z-score was not correlated with HbA1c or duration of the disease, and the average Z-score was not different in patients with microalbuminuria as compared to patients with no reported microalbuminuria. On the other hand, Z-score and BMC correlated negatively with leptin (r = -0.31; p = 0.04 and -0.60, p < 0.01, respectively). These correlations persisted after adjustment for fat mass. We conclude that not metabolic control of diabetes, but serum leptin has a negative effect on bone density in young patients with type 1 diabetes. This negative effect of leptin on bone density maybe, in part, due to deficiency of endogenous insulin secretion in these patients.
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PMID:Negative effect of leptin on bone mass in type 1 diabetes. 1869 Apr 7

Adiponectin is a 30-kDa polypeptide secreted primarily by adipose tissue and plays a key role in kidney disease. In obesity, reduced adiponectin levels are associated with insulin resistance, cardiovascular disease and obesity related kidney disease. The latter includes microalbuminuria, glomerulomegaly, overt proteinuria and focal segmental glomerulosclerosis. Adiponectin levels in type 2 diabetics also negatively correlate with early features of nephropathy. However, in patients with established chronic kidney disease, adiponectin levels are elevated and positively predict progression of disease. The mechanism of action of adiponectin in the kidney appears to be related to AMPK activation and NADPH oxidase. Further studies are needed to elucidate this pathway and investigate the role of potential targets of adiponectin-AMPK-Nox pathway for CKD as obesity-related CKD is increasing worldwide.
Best Pract Res Clin Endocrinol Metab 2014 Jan
PMID:Adiponectin effects on the kidney. 2441 47