Albuminuria reflects widespread vascular damage

Abstract

Albuminuria in Type 1 (insulin-dependent) diabetes is not only an indication of renal disease, but a new, independent risk-marker of proliferative retinopathy and macroangiopathy. The coincidence of generalised vascular dysfunction and albuminuria, advanced mesangial expansion, proliferative retinopathy, and severe macroangiopathy suggests a common cause of albuminuria and the severe renal and extrarenal complications associated with it. Enzymes involved in the metabolism of anionic components of the extracellular matrix (e.g. heparan sulphate proteoglycan) vulnerable to hyperglycaemia, seem to constitute the primary cause of albuminuria and the associated complications. Genetic polymorphism of such enzymes is possibly the main reason for variation in susceptibility.

Association between endothelial biomarkers and arterial elasticity in young adults: the CARDIA Study

“…Higher albumin excretion reflects dysfunction in small arteries, probably in part due to endothelial dysfunction. [21][22][23] This concept is consistent with our observed association between albumin excretion rate and SAE, but not LAE. Similarly, cell adhesion molecules play an important role in the pathogenesis of atherosclerosis by mediating the binding of leukocytes to the endothelium.…”

Albuminuria Increases the Risks for Both Alzheimer Disease and Vascular Dementia in Community‐Dwelling Japanese Elderly: The Hisayama Study

“…Albuminuria is well recognized as a good biomarker for endothelial dysfunction and atherosclerotic vascular disease, including stroke 28, 29. As we therefore expected, the present study showed that higher UACR level was significantly associated with a higher risk for the development of VaD, especially VaD with prior stroke events.…”

Anaemia in diabetes: is there a rationale to TREAT?

“…Anaemia is also independently associated with albuminuria ( Fig. 2), an early marker of microvascular inflammation and damage [14], which, like anaemia [3], precedes declining renal function associated with late-stage nephropathy. Recently, it has also been shown that, even in the absence of albuminuria, anaemia in patients with diabetes is largely the result of impaired renal functioning [15].…”