Tags

Type your tag names separated by a space and hit enter

Progression of borderline increases in albuminuria in adolescents with insulin-dependent diabetes mellitus.
Diabet Med 1997; 14(9):766-71DM

Abstract

We aimed to determine the natural history of borderline increases in albuminuria in adolescents with insulin-dependent (Type 1) diabetes mellitus (IDDM) and factors which are associated with progression to persistent microalbuminura. Fifty-five normotensive adolescents with IDDM and intermittent microalbuminura (overnight albumin excretion ratte of 20-200 micrograms min-1 on one of three consecutive timed collections, n = 29) or borderline albuminura (mean overnight albumin excretion rate of 7.2-20 micrograms min-1 on one of three consecutive timed collections, n = 30) were followed prospectively at 3 monthly intervals. The endpoint was persistent microalbuminuria defined as a minimum of three of four consecutive overnight albumin excretion rates of greater than 20 micrograms min-1. One hundred and forty-two adolescents with IDDM and normoalbuminura were also followed prospectively. Fifteen of the 59 patients (25.4%) with intermittent (9/29) or borderline (6/30) albuminura progressed to persistent microalbuminura (progressors) over 28 (15-50) months [median (range)] in comparison with two of the 142 patients with normoalbuminuria at entry (relative risk = 12.6; p = 0.001). Progressors to persistent microalbuminura were pubertal and had higher systolic (p = 0.02) and diastolic (p = 0.02) blood pressure, and HbA1c (p = 0.004) than non-progressors. All patients remained normotensive. Glomerular filtration rate, apolipoproteins, dietary phosphorus, protein and sodium intakes, and prevalence of smoking did not differ between progressors and non-progressors. Total renin was higher in the diabetic patients without a difference between progressors and non-progressors. In conclusion there is a relatively high rate of progression to persistent microalbuminuria in pubertal adolescents with borderline increases in albuminura and duration greater than 3 years. These patients require attention to minimize associated factors of poor metabolic control and higher blood pressure in the development of incipient nephropathy.

Authors+Show Affiliations

Department of Endocrinology, Women's and Children's Hospital, Adelaide, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

9300227

Citation

Couper, J J., et al. "Progression of Borderline Increases in Albuminuria in Adolescents With Insulin-dependent Diabetes Mellitus." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 14, no. 9, 1997, pp. 766-71.
Couper JJ, Clarke CF, Byrne GC, et al. Progression of borderline increases in albuminuria in adolescents with insulin-dependent diabetes mellitus. Diabet Med. 1997;14(9):766-71.
Couper, J. J., Clarke, C. F., Byrne, G. C., Jones, T. W., Donaghue, K. C., Nairn, J., ... McCaul, K. (1997). Progression of borderline increases in albuminuria in adolescents with insulin-dependent diabetes mellitus. Diabetic Medicine : a Journal of the British Diabetic Association, 14(9), pp. 766-71.
Couper JJ, et al. Progression of Borderline Increases in Albuminuria in Adolescents With Insulin-dependent Diabetes Mellitus. Diabet Med. 1997;14(9):766-71. PubMed PMID: 9300227.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Progression of borderline increases in albuminuria in adolescents with insulin-dependent diabetes mellitus. AU - Couper,J J, AU - Clarke,C F, AU - Byrne,G C, AU - Jones,T W, AU - Donaghue,K C, AU - Nairn,J, AU - Boyce,D, AU - Russell,M, AU - Stephens,M, AU - Raymond,J, AU - Bates,D J, AU - McCaul,K, PY - 1997/9/23/pubmed PY - 1997/9/23/medline PY - 1997/9/23/entrez SP - 766 EP - 71 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 14 IS - 9 N2 - We aimed to determine the natural history of borderline increases in albuminuria in adolescents with insulin-dependent (Type 1) diabetes mellitus (IDDM) and factors which are associated with progression to persistent microalbuminura. Fifty-five normotensive adolescents with IDDM and intermittent microalbuminura (overnight albumin excretion ratte of 20-200 micrograms min-1 on one of three consecutive timed collections, n = 29) or borderline albuminura (mean overnight albumin excretion rate of 7.2-20 micrograms min-1 on one of three consecutive timed collections, n = 30) were followed prospectively at 3 monthly intervals. The endpoint was persistent microalbuminuria defined as a minimum of three of four consecutive overnight albumin excretion rates of greater than 20 micrograms min-1. One hundred and forty-two adolescents with IDDM and normoalbuminura were also followed prospectively. Fifteen of the 59 patients (25.4%) with intermittent (9/29) or borderline (6/30) albuminura progressed to persistent microalbuminura (progressors) over 28 (15-50) months [median (range)] in comparison with two of the 142 patients with normoalbuminuria at entry (relative risk = 12.6; p = 0.001). Progressors to persistent microalbuminura were pubertal and had higher systolic (p = 0.02) and diastolic (p = 0.02) blood pressure, and HbA1c (p = 0.004) than non-progressors. All patients remained normotensive. Glomerular filtration rate, apolipoproteins, dietary phosphorus, protein and sodium intakes, and prevalence of smoking did not differ between progressors and non-progressors. Total renin was higher in the diabetic patients without a difference between progressors and non-progressors. In conclusion there is a relatively high rate of progression to persistent microalbuminuria in pubertal adolescents with borderline increases in albuminura and duration greater than 3 years. These patients require attention to minimize associated factors of poor metabolic control and higher blood pressure in the development of incipient nephropathy. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/9300227/Progression_of_borderline_increases_in_albuminuria_in_adolescents_with_insulin_dependent_diabetes_mellitus_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -