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https://hdl.handle.net/2440/7186
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Type: | Journal article |
Title: | Progression of borderline increases in albuminuria in adolescents with insulin-dependent Diabetes Mellitus |
Author: | Couper, J. Clarke, C. Byrne, G. Jones, T. Donaghue, K. Nairn, J. Boyce, D. Russell, M. Stephens, M. Raymond, J. Bates, D. McCaul, K. |
Citation: | Diabetic Medicine, 1997; 14(9):766-771 |
Publisher: | WILEY |
Issue Date: | 1997 |
ISSN: | 0742-3071 1464-5491 |
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. |
Keywords: | Humans Diabetic Nephropathies Albuminuria Diabetes Mellitus, Type 1 Disease Progression Serum Albumin Follow-Up Studies Prospective Studies Blood Pressure Time Factors Adolescent Child Female Male Glycated Hemoglobin |
DOI: | 10.1002/(SICI)1096-9136(199709)14:9<766::AID-DIA467>3.0.CO;2-X |
Published version: | http://dx.doi.org/10.1002/(sici)1096-9136(199709)14:9%3C766::aid-dia467%3E3.0.co;2-x |
Appears in Collections: | Aurora harvest 5 Paediatrics publications |
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