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Pathogenesis and treatment of microalbuminuria in patients with diabetes: the road ahead.
J Clin Hypertens (Greenwich). 2009 Nov; 11(11):636-43.JC

Abstract

The incidence of type 2 diabetes is increasing in the United States, which is expected to result in an increased prevalence of microalbuminuria and higher cardiovascular risk. Microalbuminuria is an indication that a low-level inflammatory process is ongoing. In patients with hypertension, with or without diabetes, increasing urinary albumin excretion (UAE) is associated with elevated levels of inflammatory markers, endothelial dysfunction, and platelet activation. Microalbuminuria is associated with an increased incidence of cardiovascular disease (CVD) morbidity and mortality in patients with hypertension and in those with diabetes with or without hypertension. Antihypertensive agents that modulate the renin-angiotensin-aldosterone system (RAAS) can delay the onset and reduce progression of microalbuminuria and decrease CVD morbidity and mortality in patients with diabetes. Clinical trials provide a spectrum of results regarding the protective effects of RAAS-blocking agents. Consideration of baseline blood pressure (BP), UAE and CVD risk, and the extent of BP lowering with treatment is necessary when interpreting clinical trial results in patients with microalbuminuria. It remains to be determined whether targeting the underlying inflammatory process can retard or prevent microalbuminuria progression or whether treatment of microalbuminuria can prevent end-stage renal disease or death.

Authors+Show Affiliations

Department of Medicine, University of Chicago, IL 60637, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

19878372

Citation

Kalaitzidis, Rigas, and George Bakris. "Pathogenesis and Treatment of Microalbuminuria in Patients With Diabetes: the Road Ahead." Journal of Clinical Hypertension (Greenwich, Conn.), vol. 11, no. 11, 2009, pp. 636-43.
Kalaitzidis R, Bakris G. Pathogenesis and treatment of microalbuminuria in patients with diabetes: the road ahead. J Clin Hypertens (Greenwich). 2009;11(11):636-43.
Kalaitzidis, R., & Bakris, G. (2009). Pathogenesis and treatment of microalbuminuria in patients with diabetes: the road ahead. Journal of Clinical Hypertension (Greenwich, Conn.), 11(11), 636-43. https://doi.org/10.1111/j.1751-7176.2009.00184.x
Kalaitzidis R, Bakris G. Pathogenesis and Treatment of Microalbuminuria in Patients With Diabetes: the Road Ahead. J Clin Hypertens (Greenwich). 2009;11(11):636-43. PubMed PMID: 19878372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pathogenesis and treatment of microalbuminuria in patients with diabetes: the road ahead. AU - Kalaitzidis,Rigas, AU - Bakris,George, PY - 2009/11/3/entrez PY - 2009/11/3/pubmed PY - 2010/2/3/medline SP - 636 EP - 43 JF - Journal of clinical hypertension (Greenwich, Conn.) JO - J Clin Hypertens (Greenwich) VL - 11 IS - 11 N2 - The incidence of type 2 diabetes is increasing in the United States, which is expected to result in an increased prevalence of microalbuminuria and higher cardiovascular risk. Microalbuminuria is an indication that a low-level inflammatory process is ongoing. In patients with hypertension, with or without diabetes, increasing urinary albumin excretion (UAE) is associated with elevated levels of inflammatory markers, endothelial dysfunction, and platelet activation. Microalbuminuria is associated with an increased incidence of cardiovascular disease (CVD) morbidity and mortality in patients with hypertension and in those with diabetes with or without hypertension. Antihypertensive agents that modulate the renin-angiotensin-aldosterone system (RAAS) can delay the onset and reduce progression of microalbuminuria and decrease CVD morbidity and mortality in patients with diabetes. Clinical trials provide a spectrum of results regarding the protective effects of RAAS-blocking agents. Consideration of baseline blood pressure (BP), UAE and CVD risk, and the extent of BP lowering with treatment is necessary when interpreting clinical trial results in patients with microalbuminuria. It remains to be determined whether targeting the underlying inflammatory process can retard or prevent microalbuminuria progression or whether treatment of microalbuminuria can prevent end-stage renal disease or death. SN - 1751-7176 UR - https://www.unboundmedicine.com/medline/citation/19878372/Pathogenesis_and_treatment_of_microalbuminuria_in_patients_with_diabetes:_the_road_ahead_ L2 - https://doi.org/10.1111/j.1751-7176.2009.00184.x DB - PRIME DP - Unbound Medicine ER -