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

The association between urinary albumin concentration (UAC) in a morning urine sample and medical risk factors was evaluated in a cross-sectional study of 451 type II (noninsulin-dependent) diabetic patients. The following four groups of patients were created according to their urinary albumin levels: A) normal (less than 12.5 mg/L); B) high normal (12.5-30 mg/L); C) microalbuminuria, ie, incipient nephropathy (31-299 mg/L); and D) clinical nephropathy (greater than or equal to 300 mg/L). The patients with high normal levels had higher HbA1c and systolic blood pressure levels than patients with values within normal limits. The prevalence of incipient and clinical diabetic nephropathy was 20 and 7%, respectively. Incipient nephropathy was associated with higher blood pressures and body weights. Patients with clinical nephropathy had even further increases in these parameters, were older, and had longer duration of diabetes. In both groups of nephropathy, men were preponderant. Thirty six percent of all patients and 73% of patients with clinical nephropathy were treated for hypertension; 55% were treated with insulin. The insulin-treated patients had poorer metabolic control, but there were no differences in blood pressure or serum creatinine levels as compared with those of patients not receiving insulin treatment. The proportion of patients with severe retinopathy increased with the degree of albuminuria, although 22% of the patients with clinical nephropathy continued to be nonretinopathic.
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PMID:Albuminuria and associated medical risk factors: a cross-sectional study in 451 type II (noninsulin-dependent) diabetic patients. Part 2. 183 Mar 16

The prevalence of late complications was determined in four general practices in a representative group of 137 patients with Type 2 diabetes and a control group of 128 non-diabetic individuals. Retinopathy was found in 35% of all diabetic patients, with the same prevalence below and above the age of 70 years. Microalbuminuria was found in 42% of diabetic patients and in 22% of the control group (p less than 0.001). Above 70 years of age microalbuminuria was found with increasing frequency in the control group and was not significantly higher in the diabetes group. Serum creatinine was the same in the diabetic patients and the control group. Peripheral neuropathy was found frequently in the diabetes group, but was not uncommon in the control group (abnormal temperature sensation 63 vs 49% (p less than 0.05), abnormal vibration perception 53 vs 33% (p less than 0.001), absent tendon reflex 62 vs 21% (p less than 0.001]. Above age 70 years there was again a reduction in the difference in prevalence of neuropathy between the diabetes and control groups. Ischaemic heart disease was found more frequently in the diabetes group, but only below 70 years of age (32% of diabetic patients and 14% of the control group with ischaemic changes on ECG (p less than 0.01]. Above that age 46% of the diabetes group and 45% of the control group had ECG signs of ischaemic heart disease.
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PMID:Impact of late complications in type 2 diabetes in a Dutch population. 183 May 27

It now seems worth while to identify Type 1 diabetic patients with microalbuminuria, as improved blood glucose control and reduction of arterial blood pressure will slow if not prevent the progression to persistent proteinuria. Measurement of albumin excretion rate (AER) in a timed urine sample remains the gold standard for the definition of microalbuminuria, but is not a practical screening procedure. Thus attempts have been made to relate the albumin concentration of albumin:creatinine ratio in random or first morning urine samples to AER. There is a weak correlation of albumin concentration (r = 0.32 to 0.68) and albumin:creatinine ratio (r = 0.43 to 0.54) in a random urine sample with AER, and low sensitivity and specificity of a variety of different albumin concentrations and albumin:creatinine ratios to predict microalbuminuria. The correlation of albumin concentration (r = 0.86 to 0.90) and albumin:creatinine ratio (r = 0.74 to 0.91) in an early morning urine sample with AER is stronger. Measurement of albumin:creatinine ratio in an early morning urine sample appears to be the most reliable method of screening for microalbuminuria, with sensitivity of 88 to 100% and specificity 81 to 100% depending on the cut-off ratio chosen and the definition of microalbuminuria used. If the albumin:creatinine ratio in an early morning urine sample is less than or equal to 3.5 mg mmol-1, the patient can be classed as normoalbuminuric and re-screened annually. If the ratio is greater than or equal to 10.0 mg mmol-1, confirmation of microalbuminuria should be sought in a timed urine collection and appropriate therapy begun.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Screening for microalbuminuria: which measurement? 183 60

A four-year prospective study of the factors predicting albuminuria was carried out in 172 normotensive, insulin-dependent diabetic patients without overt nephropathy. Urinary albumin excretion was estimated as the urinary albumin:creatinine ratio (UA/UC) in an early morning sample. Multivariate analysis showed that UA/UC on the return visit was positively associated with the UA/UC (p less than 0.001) and glycosylated haemoglobin (HbA1; p less than 0.001) at initial examination; weaker associations were found with a history of hospital admission (p less than 0.05) and smoking (p less than 0.05), and with treatment of blood pressure (p less than 0.05). Neither initial blood pressure, heart rate, nor creatinine clearance were significant predictors of the UA/UC. Two patients died from coronary heart disease, both of whom had raised albumin excretion at initial examination. Eleven (6.8 per cent) of the 160 patients who were studied repeatedly developed macroalbuminuria (UA/UC greater than 45.5 mg/mmol): they had a significantly higher initial UA/UC (p less than 0.005), HbA1 (p less than 0.05) and a greater frequency of retinopathy (p less than 0.05) than patients matched for age, sex and duration of diabetes who did not develop macroalbuminuria. Simultaneous measurements of the UA/UC and HbA1 should be used when screening for microalbuminuria in diabetes mellitus: patients with a high UA/UC (e.g. greater than 3.5 mg/mmol) and HbA1 (e.g. greater than 13 per cent) should be closely monitored even when blood pressure is normal.
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PMID:The determinants of early nephropathy in insulin-dependent diabetes mellitus: a prospective study based on the urinary excretion of albumin. 185 60

The relationship between blood pressure and microalbuminuria, both associated with cardiovascular disease and death, is sparsely studied in Type 2 (non-insulin-dependent) diabetes, and results may be interfered by the phenomenon of "white-coat-hypertension". We therefore investigated blood pressure by 24h ambulatory recordings (oscillometry) and examined whether blood pressure related to the level of urinary albumin excretion rate (UAER) by synchronous 24h collections. Seventeen diabetics (50-75 years of age) with microalbuminuria (15 less than UAER less than 200 micrograms/min) (DM), 15 with normal urinary albumin excretion (DN) and 10 healthy controls (C) participated. All groups were of comparable sex, age degree of obesity and had normal serum creatinine, and the groups of diabetics were of similar known duration, glycemic control and frequency of antihypertensive treatment. Blood pressures measured at the clinic were significantly higher (p less than 0.01) than 24h recordings. An average systolic pressure of 142 +/- 11 mmHg in DN was increased (p less than 0.01) as compared to C: 130 +/- 10 mmHg, but no further increase was seen in DM: 146 +/- 19 mmHg. Diastolic pressures were not different among the groups (C: 77 +/- 8 mmHg, DN: 80 +/- 11 mmHg, DM: 79 +/- 9 mmHg). Average 24h systolic pressure correlated to the UAER r = 0.61, p = 0.009 in DM, whereas not in DN. By the present method we found isolated systolic hypertension in Type 2 diabetes which may express "vascular stiffness". There was, however, no further rise in blood pressure in patients with microalbuminuria, but in these patients albuminuria may be pressure dependent and/or expressive of vascular pathology.
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PMID:Blood pressure by 24 h ambulatory recordings in type 2 (non-insulin dependent) diabetics. Relationship to urinary albumin excretion. 186 38

Urinary albumin excretion (UAE) was estimated by radioimmunoassay in 316 non-insulin dependent diabetic patients (NIDDM), with diabetes for 10 or more years and proteinuria less than 150 mg/24 h. Albuminuria was determined in 24 h collection of urine in 259 patients but in the other 57, a random sample was used. The mean UAE was 23 +/- 45.3 (SD) micrograms/mg creatinine in the patients against 4.4 +/- 2.7 micrograms/mg in the controls (30). Ninety patients (28.5%) had microalbuminuria i.e., the UAE exceeded, 20 micrograms/mg creatinine. A higher percentage (31.7%) of men had microalbuminuria than women (23.6%). The presence of microalbuminuria was similar in the insulin-treated and in oral drug-treated patients (29.6% and 26.5% respectively). Stepwise multiple regression analysis using albumin/creatinine ratio as the dependent variable showed that factors such as blood pressure, blood glucose, HbA1, body mass index, sex, age, duration of diabetes and the association of vascular complications of diabetes did not have significant correlation to microalbuminuria. Creatinine clearance showed a significant inverse correlation to the albumin/creatinine ratio. Although the prevalence of microalbuminuria in NIDDM in this study is not significantly different from those reported from other countries, the morbidity index due to kidney disease could be high due to the large absolute number involved in our country. This underscores the need for early detection of the disease and institution of preventive measures to arrest its progression.
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PMID:Microalbuminuria in NIDDM patients in south India. 187 86

The effect of the mucolytic agent bromhexine, 72 mg daily for one month, on albumin excretion in insulin dependent diabetes was investigated in a double-blind, randomised, cross-over, placebo-controlled study. Nine patients with normal albumin excretion [overnight albumin excretion rate 3.2 (2.1-8.8) micrograms/min.; mean (range)], six with microalbuminuria [36 (22-95) micrograms/min.] and six with macroalbuminuria [321 (201-1215) micrograms/min.] participated. Albumin excretion was similar after treatment with bromhexine and placebo in all 3 groups [normoalbuminurics 3.6 (1.7-13.5) versus 3.3 (1.9-13.2) micrograms/min.; microalbuminurics 40 (20-128) versus 37 (20-103); macroalbuminurics 396 (247-2160) versus 443 (292-2592)]. Excretion of beta 2-microglobulin and creatinine clearance were identical at the end of each treatment. Blood glucose control and blood pressure remained constant throughout the study in the 3 groups. We conclude that bromhexine 72 mg daily for 1 month had no effect on albumin excretion in IDDM patients with normal and pathological albuminuria.
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PMID:The effect of bromhexine on albumin excretion in insulin dependent diabetes. 188 76

Renal handling of glycated albumin in diabetic nephropathy was examined by studies on renal selectivity for glycated albumin in 23 normal controls and 52 patients with non-insulin-dependent diabetes mellitus (NIDDM) with various degrees of nephropathy. The serum and urinary levels of glycated albumin were measured by enzyme-immunoassay with monoclonal antibody to glucitol-lysine residues in human glycated albumin. The diabetic patients were divided into 3 groups according to the albumin index (AI): patients with normoalbuminuria [AI less than or equal to 30 mg/g creatinine(Cr)], with microalbuminuria (30 less than AI less than or equal to 270 mg/g Cr), and with macroalbuminuria (AI greater than 270 mg/g Cr). The renal selectivity for glycated albumin was calculated from the ratio of the urinary to serum level of glycated albumin. In the controls, the renal selectivity was as high as 4.40 +/- 0.48, and significantly higher than those in patients with normo- (2.87 +/- 0.29), micro- (1.72 +/- 0.20) and macroalbuminuria (1.26 +/- 0.23). The renal selectivity was inversely correlated with the AI in diabetic patients (r = -0.58, P less than 0.01). These data indicate that glycated albumin was selectively excreted in the urine and that the renal selectivity in diabetic patients gradually decreased to a value of 1 with increase in albuminuria. When the patients with normoalbuminuria were divided into two subgroups with high and low albumin excretion, the renal selectivities for glycated albumin in both subgroups were still significantly lower than that in controls. These results suggested that early diabetic nephropathy which cannot be detected clinically by albuminuria can be diagnosed by measurement of renal selectivity for glycated albumin.
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PMID:Renal handling of glycated albumin in non-insulin-dependent diabetes mellitus with nephropathy. 188 45

A series of 72 type I diabetics was grouped according to the mean value of 24-h albuminuria (AU) determined from three 24-h urine collections: group A (n = 49, normoalbuminuria, AU less than or equal to 26 mg/24 h), group B (n = 16, microalbuminuria, AU less than or equal to 26 mg/24 h), group C (n = 7, clinically significant proteinuria, AU greater than 260 mg/24 h). Glycosylated hemoglobin (GHb) was examined five times in three-month intervals. Systolic and diastolic blood pressure (BPs and BPD) were determined from four values taken in the course of one year. Glomerular filtration (GF) was established a single examination of 24-h creatinine clearance. Fluorescent angiography was used to examine the fundus of the eye. The function of the cardiovascular autonomic nervous system was assessed on the basis of three tests: variation of heart rate during deep respiration, response of heart rate to upright position, Valsalva's maneuver. Group C had the longest duration of diabetes, the highest GHb, the lowest GF, and the highest BPS and BPD values. The number of diabetics with different findings on the fundus of the eye (normal finding/simple retinopathy/preproliferative and proliferative retinopathy) was as follows: group A--15/31/3, group B--9/6/1, group C--0/3/4. Group C exhibited the most pronounced derangement of the cardiovascular autonomic nervous system, whose extent depended on the length of diabetes duration and on the quality of metabolic compensation. Between the groups A and B no significant differences were found in any of the parameters studied.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The importance of albuminuria in the detection of diabetic nephropathy and its relation to the development of retinopathy and autonomic neuropathy in type I diabetes]. 191 3

Latent diabetic nephropathy with no complication such as retinopaty and hypertension was treated with Alacepril, an ACE inhibitor. This study enrolled 10 patients with microalbuminuria ranging from 5 mg/day (5 mg/gCr) to 50 mg/day (30 mg/gCr). Histological changes due to diabetic nephropathy were confirmed by renal biopsy performed in 4 of 10 patients. All the patients were divided into 2 groups; 5 patients were given 25 mg of Alacepril for 6 months and the remaining 5 patients were employed as the control. As the results, the mean blood pressure was decreased from 92.7 +/- 9.0 mmHg to 87.3 +/- 11.3 mmHg in Alacepril group but these changes were not statistically significant. Microalbuminuria were significantly decreased from 17.33 +/- 7.82 mg/gCr to 10.43 +/- 4.14 mg/gCr during 6 months in the Alacepril group while in the control group, no significant changes were observed in blood pressure and microalbuminuria. Creatinine clearances were not significantly changed in both groups. These findings suggest that Alacepril is useful in improving microalbuminuria of latent diabetic nephropathy.
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PMID:[Treatment of latent diabetic nephropathy with ACE inhibitor alacepril]. 192 Sep 34


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