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)

The altered excretion of isoenzymes of amylase in urine was used as an early indicator of the loss of electric charges in the glomerular basement membrane, in 202 juvenile-onset insulin-dependent diabetic patients, compared with the pattern of excretion in 51 normal subjects matched for age and sex. Diabetics showed an increased excretion of salivary amylase. The salivary to pancreatic amylase ratio in urine (S/P ratio) was always below 1 in control subjects, but was elevated in 33.2% of diabetics, although microalbuminuria was present in only 26.2% of diabetic patients. The concentrations of other proteins in urine were within the reference ranges in nearly all patients, indicating that the kidney was not seriously affected. The increased salivary amylase excretion was not due to changes in the plasma concentration of any of the isoamylases, but to a real increase in excretion, as its fractional excretion in relation to creatinine clearance was clearly increased (1.0 +/- 0.7 vs. 1.52 +/- 1.99, p < 0.05), and the ratio of their clearances was also increased (0.35 +/- 0.18 vs. 0.49 +/- 0.61, p > 0.05). Moreover, the prevalence of altered S/P ratios was higher than the prevalence of microalbuminuria (36.6% vs. 18.8% of patients in the first decade of evolution of insulin-dependent diabetes mellitus). Altered S/P ratios were most prevalent in the first decade, whereas microalbuminuria was most prevalent in the second decade of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Early changes of urinary amylase isoenzymes in diabetes mellitus. 128 27

The purpose of the present study was to assess the efficacy and tolerability of diuretic-free antihypertensive therapy with a calcium antagonist and/or an angiotensin converting enzyme (ACE) inhibitor in patients with diabetes mellitus. 54 hypertensive [blood pressure (BP) above 140/90mm Hg] patients with diabetes mellitus type 1 (n = 7) or 2 (n = 47) and normal serum creatinine levels (mean 82 +/- 6 mumol/L) received either verapamil or enalapril after a 2-week washout and a 4-week placebo phase. If BP remained elevated, both agents were combined. Verapamil or enalapril alone normalised diastolic BP (to less than 90mm Hg) in 36 patients; verapamil decreased BP from 159/98 to 147/87mm Hg (n = 19, p < 0.001) and enalapril decreased BP from 166/99 to 146/88mm Hg (n = 17, p < 0.001). In 18 patients who remained hypertensive after 10 weeks of monotherapy, a combination of both drugs decreased BP from 169/104 to 151/90mm Hg (p < 0.001). Overall, 87% of patients achieved a target BP response at 30 weeks. Urinary albumin as related to creatinine excretion (UAE; micrograms albumin:mg creatinine) was on average not significantly changed after verapamil or enalapril treatment, alone or combined. Nevertheless, in patients with initial microalbuminuria, UAE decreased (p < 0.05) during enalapril treatment. Serum potassium, total lipids, high density lipoprotein cholesterol, low density lipoprotein cholesterol, glycosylated haemoglobin, serum C peptide and fructosamine levels were not significantly modified by treatment. Subjective tolerability of the drugs was also generally good. Thus, in hypertensive patients with diabetes, a diuretic-free therapy based on the calcium antagonist verapamil or the ACE inhibitor enalapril, alone or combined, can effectively decrease BP without adversely affecting carbohydrate and lipid metabolism.
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PMID:Swiss hypertension treatment programme with verapamil and/or enalapril in diabetic patients. 128 88

We investigated the frequency and the clinical significance of microalbuminuria (UA) in 312 hospital patients suspected of renal disorders, but with normal or borderline levels of urinary total protein (UTP). Approximately one-third of the patients with urinary total protein < 300 mg/g creatinine had microalbuminuria, above the reference interval (< 32 mg/g creatinine). In contrast, only 10% of the patients with elevated total urinary protein above the reference interval (> 200 mg/g creatinine) did not have microalbuminuria. About half of the patients with elevated UA had diabetes mellitus, hypertension, an immune-related disorder, or had undergone a recent renal transplant. About half of the patients with borderline elevated UTP (100 to 300 mg/g creatinine) did not have any obvious renal problem. These data demonstrate that: 1) microalbuminuria occurs very commonly in hospital patients, 2) it is a more sensitive and specific assay for the early detection of many renal disorders compared to urinary total protein, especially when the latter test is normal or borderline elevated; and 3) a thorough patient history is required for interpretation of microalbuminuria in diabetes to eliminate other complicating factors.
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PMID:Microalbuminuria: frequency and clinical significance in hospital patients. 130 30

To detect early renal involvement in young diabetic patients (IDDM), urinary protein excretion and renal function were examined in 110 patients aged 5.9-25.0 years. Clearances of inulin and PAH were determined as well as albumin (Alb), IgG, N-acetyl-beta-D-glucosaminidase (NAG) and creatinine (Cr) excretion rates (UV). The patients were grouped according to IDDM duration (2- less than 5, 5-10 and greater than 10 years) and albumin excretion rate (non-albuminuria less than 20, microalbuminuria 20-200, and albuminuria greater than 200 micrograms/min per 1.73 m2). Four patients had overt albuminuria, 17 microalbuminuria (equally distributed among the duration groups). Grouped according to albumin excretion rate, the mean GFR was increased in those without albuminuria but 'normalized' in patients with microalbuminuria/albuminuria. Grouped according to albumin excretion rate and the duration of the disease, the non-albuminuric patients with IDDM for greater than 10 years had a lower GFR than those with a shorter duration of IDDM. The patients with microalbuminuria/albuminuria and IDDM for less than 5 years had a reduced GFR. Patients with increased NAG excretion rate had lower Na excretion rate, lower fractional Na excretion and greater creatinine excretion than those with normal NAG excretion. Albumin excretion correlated with IgG excretion, but also with NAG excretion. Our results suggest that early albuminuria in IDDM is of both glomerular and tubular origin. The hyperfiltration declines with increasing albumin excretion but also with the duration of the disease.
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PMID:Urinary protein excretion and renal function in young people with diabetes mellitus. 132 Feb 27

To test the hypothesis that a high plasma prorenin can be used as an early marker of microvascular complications in patients with diabetes mellitus plasma prorenin was measured in 44 patients with urinary albumin excretion between 30 and 300 mg/24 h (microalbuminuria) and 120 patients with urinary albumin excretion below 30 mg/24 h (normoalbuminuria). A high plasma prorenin was associated with diabetic retinopathy, particularly the proliferative type, serum creatinine and the 24 h urinary albumin excretion rate. Plasma prorenin was not correlated with age, duration of diabetes, glycosylated hemoglobin, blood glucose, and blood pressure. The association between elevated plasma prorenin and retinopathy remained significant after adjustment for serum creatinine and albumin excretion. Independent of the presence or absence of microalbuminuria, the mean plasma level of prorenin was not above normal in patients without retinopathy and was 2 to 3 times normal in patients with proliferative retinopathy. Thus retinopathy appears to be an important determinant of abnormally high plasma prorenin. Angiotensin converting enzyme (ACE) was elevated in the patients with diabetes mellitus as compared to control subjects but the plasma levels of ACE in diabetics with normoalbuminuria was not significantly different from the group with microalbuminuria. Plasma prorenin was not associated with ACE. A plasma level of prorenin of 225 mU/L had a sensitivity of 0.84 and a specificity of 0.82 for detecting the presence of microalbuminuria.
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PMID:Plasma prorenin as an early marker of microvascular disease in patients with diabetes mellitus. 132 26

Urinary albumin concentration (UA) and albumin/creatinine ratio (UA/UC) in early morning specimens were assayed in 225 consecutive pregnant women at 20, 26, 28 and 30 weeks of gestation. 193 did not develop preeclampsia (control group), 14 developed preeclampsia later (preeclamptic group), 9 were excluded and 9 dropped out. Reference intervals of UA and UA/UC of healthy pregnant women (wk 20-30) was obtained. A statistically significant increase in urinary albumin excretion was observed with increasing gestational age as a normal phenomenon. There was no significant difference in the values of UA and UA/UC in the preeclamptic group when compared with the control group at the same stage of gestation. This indicates that microalbuminuria cannot be used as a predictor of preeclampsia.
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PMID:Microalbuminuria as a predictor of preeclampsia. 132 8

Microalbuminuria may be due to increased glomerular capillary pressure. In turn, this increased pressure may be associated to augmented protein intake or reduction of renal mass. 85 normal subjects who had a unilateral nephrectomy were studied. Creatinine clearance, microalbuminuria and blood pressure were measured. Hyperfiltration was evaluated by comparison of creatinine clearance before and after nephrectomy. Protein intake was evaluated by a nutritional questionnaire. Hyperfiltration was estimated as 38% and microalbuminuria was not different in patients submitted to nephrectomy (9.8 micrograms/min) compared to controls (9.7). Microalbuminuria post nephrectomy was not correlated to level of hyperfiltration, protein intake, age, blood pressure or time after surgery. These results suggest that the remaining kidney is able to double the excretion of albumin with a likely increase in glomerular filtration and intracapillary pressure.
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PMID:[Microalbuminuria after unilateral nephrectomy in humans: study of effects of dietary protein]. 134 May 48

We compared the urinary excretion of albumin, transferrin, N-acetyl-beta-D-glucosaminidase and alpha-1-microglobulin in 78 Type 1 (insulin-dependent) diabetic patients: 39 with retinopathy and 39 without. The two groups were matched for age, sex and duration of diabetes. The patients with retinopathy had increased excretion (median and range) of albumin [1.7(0.3-399.1) versus 1.0(0.3-116.6) mg/mmol creatinine, P less than 0.05], transferrin [114.2 (4.1-37126.2) versus 33.4 (1.0-4176.7) micrograms/mmol creatinine, P less than 0.01] and N-acetyl-beta-D-glucosaminidase [23.8 (1.1-119.1) versus 15.0 (0.1-65.1) mumol/h/mmol creatinine, P less than 0.05] but not alpha-1-microglobulin. Transferrin excretion correlated with albumin excretion. The prevalence of increased transferrin excretion (transferrinuria) was greater than that of microalbuminuria in patients both with and without retinopathy (P less than 0.01 in both cases). Urinary transferrin seems likely to be predominantly of glomerular origin and merits prospective longitudinal evaluation as a potential index of the microangiopathic process.
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PMID:Glomerular and tubular proteinuria in type 1 (insulin-dependent) diabetic patients with and without retinopathy. 137 79

Renal function as a sensitive biomarker of aging has been studied in specific pathogen-free (SPF) Fischer 344 rats (n = 211), and results are presented according to animal age (5, 8, 12, 18, 24 mo), sex, and diet (ad libitum vs. 40% calorie restriction). Plasma creatinine concentration, endogenous creatinine clearance, total protein excretion, and albumin excretion were measured. Kidney histology was evaluated by light microscopy. In both calorie-restricted and ad libitum-fed animals, kidney weight (KW) and body weight (BW) showed parallel changes with age. The KW-to-BW ratio was unaffected by age in all groups. There was no alteration in plasma creatinine concentration as a function of age or diet. In these SPF animals there was also no change in glomerular filtration rate with age. In animals fed ad libitum, albumin and protein excretion increased with age (females: 0.39 +/- 0.05 at 5 mo vs. 7.4 +/- 2.6 mg protein.24 h-1.g KW-1 at 24 mo; males: 4.1 +/- 0.6 at 5 mo vs. 15 +/- 3 mg protein.24 h-1.g KW-1 at 24 mo). The higher protein excretion rate in all males at 5 mo reflected the excretion of sex-dependent low-molecular-weight proteins that commenced with sexual maturation. Calorie restriction prevented the age-dependent increase in total protein excretion. Kidney histopathology was positively correlated with total protein and albumin excretion. Microalbuminuria preceded the development of lesions detectable by light microscopy. These observations support the concept that microalbuminuria in this model is a sensitive and early biomarker of nephropathy that can be monitored easily and noninvasively.
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PMID:Calorie restriction decreases microalbuminuria associated with aging in barrier-raised Fischer 344 rats. 141 85

Microalbuminuria has been shown to be important for the diagnosis and prognosis of glomerular nephropathy. A few studies in normal healthy children were performed. The concentration of albumin was determined in 171 samples of the first morning urine by an immunoturbidimetric method. Microalbumin/creatinine ratio values were 4.07 +/- 0.11 mg/mmol, 1.16 +/- 0.10 mg/mmol and 0.88 +/- 0.11 mg/mmol in children of ages 4 days-1 year, 1-7 years and 7-15 years, respectively. We found a negative inverse correlation (r = 0.31; p < 0.05) between age and microalbumin/creatinine ratio.
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PMID:[Evaluation of microalbuminuria in children]. 144 12


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