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Stable glomerular filtration rate in normotensive IDDM patients with stable microalbuminuria. A 5-year prospective study.
Diabetes Care. 1997 Mar; 20(3):286-9.DC

Abstract

OBJECTIVE

To investigate the long-term course of glomerular filtration rate (GFR) in IDDM patients with microalbuminuria in order to identify patients with stable or declining kidney function over a 5-year study.

RESEARCH DESIGN AND METHODS

Forty normotensive (129 +/- 11/80 +/- 8 mmHg) IDDM patients with persistent microalbuminuria (mean urinary albumin excretion [UAE] 84 mg/24 h [range 30-300]) were followed prospectively for 5 years of clinical examinations that included the measurement of GFR (51Cr-labeled EDTA clearance) at least once a year. The mean GFR at baseline was 120 +/- 18 ml x min-1.1 x 73 m-2.

RESULTS

Using multiple regression analysis, the rate of decline in GFR was independently correlated to onset of diabetic nephropathy (P < 0.001) and systolic blood pressure (sBP) at baseline (P < 0.05). Increase in UAE was correlated to the mean HbA1c during the observation period. Out of 40 patients, 14 progressed to diabetic nephropathy (UAE > 300 mg/24 h). These patients had a significant reduction in GFR (mean -2.2 +/- 3.8 ml x min-1 x year-1; P = 0.05), while GFR remained stable in the remaining 26 patients with nonprogressive microalbuminuria (change in GFR 0.5 +/- 2.1 ml x min-1 x year-1; NS). The difference in the rate of decline of GFR was significant (mean 2.7 ml x min-1 x year-1; P < 0.05).

CONCLUSIONS

Normotensive IDDM patients with nonprogressive microalbuminuria have a stable GFR. Progression of UAE to diabetic nephropathy heralds a progressive loss of kidney function. Efforts should be made to prevent the progression from microalbuminuria to diabetic nephropathy in every IDDM patient with microalbuminuria.

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Authors+Show Affiliations

Mathiesen ER
Steno Diabetes Center, Copenhagen, Denmark.
Feldt-Rasmussen B
No affiliation info available
Hommel E
No affiliation info available
Deckert T
No affiliation info available
Parving HH
No affiliation info available

MeSH

AdultAlbuminuriaDiabetes Mellitus, Type 1Diabetic NephropathiesFollow-Up StudiesGlomerular Filtration RateHumansKidney GlomerulusMultivariate AnalysisProspective StudiesTime Factors

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9051373

Citation

Mathiesen, E R., et al. "Stable Glomerular Filtration Rate in Normotensive IDDM Patients With Stable Microalbuminuria. a 5-year Prospective Study." Diabetes Care, vol. 20, no. 3, 1997, pp. 286-9.
Mathiesen ER, Feldt-Rasmussen B, Hommel E, et al. Stable glomerular filtration rate in normotensive IDDM patients with stable microalbuminuria. A 5-year prospective study. Diabetes Care. 1997;20(3):286-9.
Mathiesen, E. R., Feldt-Rasmussen, B., Hommel, E., Deckert, T., & Parving, H. H. (1997). Stable glomerular filtration rate in normotensive IDDM patients with stable microalbuminuria. A 5-year prospective study. Diabetes Care, 20(3), 286-9.
Mathiesen ER, et al. Stable Glomerular Filtration Rate in Normotensive IDDM Patients With Stable Microalbuminuria. a 5-year Prospective Study. Diabetes Care. 1997;20(3):286-9. PubMed PMID: 9051373.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stable glomerular filtration rate in normotensive IDDM patients with stable microalbuminuria. A 5-year prospective study. AU - Mathiesen,E R, AU - Feldt-Rasmussen,B, AU - Hommel,E, AU - Deckert,T, AU - Parving,H H, PY - 1997/3/1/pubmed PY - 1997/3/1/medline PY - 1997/3/1/entrez SP - 286 EP - 9 JF - Diabetes care JO - Diabetes Care VL - 20 IS - 3 N2 - OBJECTIVE: To investigate the long-term course of glomerular filtration rate (GFR) in IDDM patients with microalbuminuria in order to identify patients with stable or declining kidney function over a 5-year study. RESEARCH DESIGN AND METHODS: Forty normotensive (129 +/- 11/80 +/- 8 mmHg) IDDM patients with persistent microalbuminuria (mean urinary albumin excretion [UAE] 84 mg/24 h [range 30-300]) were followed prospectively for 5 years of clinical examinations that included the measurement of GFR (51Cr-labeled EDTA clearance) at least once a year. The mean GFR at baseline was 120 +/- 18 ml x min-1.1 x 73 m-2. RESULTS: Using multiple regression analysis, the rate of decline in GFR was independently correlated to onset of diabetic nephropathy (P < 0.001) and systolic blood pressure (sBP) at baseline (P < 0.05). Increase in UAE was correlated to the mean HbA1c during the observation period. Out of 40 patients, 14 progressed to diabetic nephropathy (UAE > 300 mg/24 h). These patients had a significant reduction in GFR (mean -2.2 +/- 3.8 ml x min-1 x year-1; P = 0.05), while GFR remained stable in the remaining 26 patients with nonprogressive microalbuminuria (change in GFR 0.5 +/- 2.1 ml x min-1 x year-1; NS). The difference in the rate of decline of GFR was significant (mean 2.7 ml x min-1 x year-1; P < 0.05). CONCLUSIONS: Normotensive IDDM patients with nonprogressive microalbuminuria have a stable GFR. Progression of UAE to diabetic nephropathy heralds a progressive loss of kidney function. Efforts should be made to prevent the progression from microalbuminuria to diabetic nephropathy in every IDDM patient with microalbuminuria. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/9051373/Stable_glomerular_filtration_rate_in_normotensive_IDDM_patients_with_stable_microalbuminuria__A_5_year_prospective_study_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=9051373.ui DB - PRIME DP - Unbound Medicine ER -