Effect of glycaemic control and duration of disease on overnight albumin excretion in diabetic children.

Rowe, David J.; Hayward, M.; Bagga, Herman S.; Betts, Peter

doi:10.1136/bmj.289.6450.957

Cited by 68 publications

(29 citation statements)

References 13 publications

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“…A study at mean age 10 yr and mean duration of diabetes 3.8 yr found no difference in overnight AER compared with a control group (37), and similar AER results were also found in a study using timed 3-h morning collections (51). Studies in slightly older diabetic children (mean age 13 yr) with longer diabetes duration (5 and 7 yr respectively) found higher AER in the T1DM children (52,53), and similar results were found in 24-h urine collections (54,55).…”

Section: Discussionmentioning

confidence: 50%

Albumin Excretion Rate in Normal Adolescents

Rademacher¹,

Mauer

Jacobs³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: Although albumin excretion rates have been related to cardiovascular morbidity and mortality in both diabetic and nondiabetic adults, little is known about the relation between albuminuria and either cardiovascular risk factors or the insulin resistance syndrome in adolescents. A normal range for albumin excretion in adolescents was established, correlations between albumin excretion and cardiovascular risk factors were evaluated, and albumin excretion in normal adolescents was compared with that in type 1 diabetes mellitus adolescents.Design, setting, participants, & measurements: Albumin excretion rate was measured in 368 normal and 175 diabetic adolescents. Multiple regression analysis was used to predict the relation of age, sex, Tanner stage, body mass index, and systolic blood pressure to albumin excretion in both cohorts. In addition, correlations between albumin excretion and age, blood pressure, body mass index, lipids, and measurements of insulin resistance were performed in the normal adolescents.Results: Mean albumin excretion was significantly lower in normal adolescents (4.0 g/min) than in type 1 diabetic adolescents (5.0 g/min). Albumin excretion increased with age in diabetics. Albumin excretion did not significantly correlate with any measure of cardiovascular risk or insulin resistance but did significantly correlate with fasting insulin.Conclusions: Albumin excretion rate is not related to insulin resistance or traditional cardiovascular risk factors in adolescence but is related to fasting insulin. Diabetic adolescents have increased albumin excretion compared with normal adolescents.

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Section: Discussionmentioning

confidence: 50%

Albumin Excretion Rate in Normal Adolescents

Rademacher¹,

Mauer

Jacobs³

et al. 2008

Clinical Journal of the American Society of Nephrology

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“…Previous investigations on the prevalence of microalbuminuria in children and adolescents with type 1 diabetes have reported different figures that range between 10% and 20%. A prevalence of microalbuminuria of 10% was reported by Salardi et al [18], and that of 15% was found by Rowe et al [19], and Davies et al [20], while 20% was reported by Mathiesen et al [21] and Dahlquist and Rudberg [22]. This variation could be explained, in part, by the differences in methods of urine collection, analysis techniques, and cut-off points for microalbuminuria, but it may signify real ethnic or geographical differences.…”

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confidence: 68%

Microalbuminuria in Young Sudanese Patients with Type 1 Diabetes

et al. 1993

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Overnight urinary albumin excretion (UAE) was measured in 51 patients, nine to 18 years old, with type 1 (insulindependent) diabetes mellitus and in 22 healthy subjects using radioimmunoassay. Thirteen diabetic patients (25.5%) had microalbuminuria defined as UAE rate between 20 and 200 (μg/min. Eleven of these patients were over 13 years of age. This gives a frequency of microalbuminuria of 42% (11/26) in the diabetic children and adolescents in the age group 14-18 years. UAE rate was positively correlated with both age at diagnosis and duration of diabetes. Arterial blood pressure, systolic and diastolic, glycosylated hemoglobin (HbA 1c ) and insulin dosage U.kg-1.day-1 were significantly higher (P<0.001) in the diabetic patients with microalbuminuria compared to the diabetic patients with normal UAE rate. Retinal changes were also more common in the microalbuminuric diabetic patients than in the diabetic patients without microalbuminuria (P<0.01). This study has revealed a high prevalence of microalbuminuria in young Sudanese patients with type 1 (insulin-dependent) diabetes mellitus and emphasized the importance of routine screening of diabetic children after the age of 12 years. Ann Saudi Med 1993;13(6) Despite the marked reduction in the incidence of diabetic nephropathy that occurred in recent decades, it is estimated that between 30% to 35% of the patients with type 1 (insulin-dependent) diabetes mellitus are still at risk of developing this complication [1]. Nephropathy is regarded as the most serious late diabetic complication because it is associated with 100 times greater risk of mortality than in the background population [2]. The median survival period of diabetic patients after onset of overt albuminuria was reported as less than 10 years [3]. In 1963, a sensitive method for detecting urinary albumin in low concentrations was described [4], and since then, many studies have been performed to establish the rate of urinary albumin excretion (UAE) that is predictive of later nephropathy. It was concluded from several reports that a cut-off level of 20 μg/min would include almost 80% of the patients at risk [5][6][7]. A rate of UAE between 20 and 200 (μg/min was therefore defined as microalbuminuria and is thought to signify incipient nephropathy [8]. Previous studies have shown recognizable variations in the prevalence of microalbuminuria in diabetic patients and have been inconclusive regarding the relationship between UAE and metabolic control [9][10][11][12]. The aim of the present study was to determine the prevalence of at risk values of UAE in young Sudanese diabetic patients and to explore its relation to age and glycemic control. Subjects and Methods SubjectsThe subjects were selected from the children and adolescents with type 1 diabetes who regularly attend the diabetic clinic at the University Hospital in Khartoum, Sudan. The patients who were between nine and 18 years of age and who had the disease for more than one year (62 children) were invited to participate in the study. Thirty heal...

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“…By the time renal function tests become abnormal and albuminuria is detectable by Standard clinical tests, diabetic nephropathy is irreversible (1). However, glycaemic and blood pressure control (l, 2) might retard or arrest the progression of diabetic nephropathy in the state of microalbuminuria (3,4). The degree of microalbuminuri is also predictive of the progression to clinical proteinuria in type I (5-7) and in type II (8) diabetics.…”

Section: Introductionmentioning

confidence: 99%

“…Low concentrations of albumin can also be ineasured by radial-immunodiffusion (7,12). Immunoturbidimetric methods for the measurement of albumin have been published (4,13,14). We present the adaptation of an immunoturbidimetric method for the determination of low concentrations of albumin in uri e to a Hitachi analyser type 704 or 705, that enables routine measurements of urine samples in a short time (180 samples per hour) at low cost.…”

Section: Introductionmentioning

confidence: 99%

Immunoturbidimetric Assay for the Determination of Microalbuminuria Using the Hitachi Analyser

Landgraf-Leurs

Modi²,

Horn³

et al. 1987

Clinical Chemistry and Laboratory Medicine

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Summary:A sensitive and specific Immunoturbidimetric method is described for the determination of low concentrations of urinary albumin using a Hitachi 704 or 705 analyser. The sensitivity was l mg/1 and the precision attained was good (CV 15%, 7% and 6% for low, medium and higher albumin concentrations). The assay was used to determine urinary albumin excretion rates in healthy controls (< 15 μg/min) and in type I diabetics. Since microalbuminuria (30-200 μg/min) seems to be a gpod predictor for the development of diabetic nephropathy and other late diabetic complications, this assay is suitable for the necessary screening and follow-up of diabetic nephropathy. In contrast to RIA methods, no radioactive tracers are needed.

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Effect of glycaemic control and duration of disease on overnight albumin excretion in diabetic children.

Cited by 68 publications

References 13 publications

Albumin Excretion Rate in Normal Adolescents

Albumin Excretion Rate in Normal Adolescents

Microalbuminuria in Young Sudanese Patients with Type 1 Diabetes

Immunoturbidimetric Assay for the Determination of Microalbuminuria Using the Hitachi Analyser

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