High‐normal levels of albuminuria predict the development of micro‐ and macroalbuminuria and increased mortality in Brazilian Type 2 diabetic patients: an 8‐year follow‐up study

Murussi, Marcia; Campagnolo, Nicole; Beck, M; Gross, Jorge Luiz; Silveiro, Sandra Pinho

doi:10.1111/j.1464-5491.2007.02209.x

Cited by 37 publications

(36 citation statements)

References 32 publications

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“…This idea is corroborated by our own previous findings, as well as by those of other studies, which have demonstrated that even "highnormal" albuminuria may be predictive of advanced kidney disease and mortality 1,21 . Surprisingly, it was only recently that a candidate liquid chromatography-mass spectrometry (LC-MS/ MS) was developed as a reference measurement procedure to assess UA 22 .…”

Section: Discussionsupporting

confidence: 80%

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Availability of urinary albumin measurement in Southern Brazilian Laboratories

Soares¹,

Cheuiche²,

Silva³

et al. 2015

cbr

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Section: Discussionsupporting

confidence: 80%

“…Diabetic kidney disease (DKD) is a serious microvascular complication of diabetes mellitus (DM), and the leading worldwide cause of end-stage renal disease 1,2 . The early detection of DKD allows for the use of strategies to halt its development or at least delay the progression of the disease 3 .…”

mentioning

confidence: 99%

Availability of urinary albumin measurement in Southern Brazilian Laboratories

Soares¹,

Cheuiche²,

Silva³

et al. 2015

cbr

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“…The univariate analysis indicated that, in comparison to that of a normoalbuminuria group, the microalbuminuria development group had longer diabetes duration (9.34 vs. 7.95 years), had more subjects on insulin therapy (32.4% vs. 14.2%), had a poorer glycemic control (8.71% vs. 7.78%), and had a higher baseline UACR (15.31 mg/g vs. 9.85 mg/g) ( Table 1). Though more hypertension subjects were included (44.1% vs. 34.4%) in the microalbuminuria development group (p ¼ 0.052), the average blood pressure levels were similar between the microalbuminuria and control groups.…”

Section: Resultsmentioning

confidence: 97%

Effect of glycemic control on microalbuminuria development among type 2 diabetes with high-normal albuminuria

et al. 2013

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This study was aimed at revealing the factors and the interrelationships between factors on microalbuminuria development among type 2 diabetes (T2D) patients. Between 2004 and 2011, 461 T2D patients with a baseline urine albumin-to-creatinine ratio (UACR) of 530 mg/g, and an estimated glomerular filtration rate (eGFR) of 460 mL/min were evaluated retrospectively. Sixty-eight (14.8%) subjects had developed microalbuminuria in a mean follow-up of 6.82 years. Statistical analysis had revealed that the higher baseline UACR (10 mg/g; sensitivity, 80.9%, specificity, 63.6%; AUC ¼ 0.774) and glycohemoglobin level (HbA1c) (8%; sensitivity, 72.1%, specificity, 61.6%; AUC ¼ 0.698) were the two independent microalbuminuria risk factors. When considering the risk of microalbuminuria, the data were normalized with respect to subjects with low-normal UACR (510 mg/g) and HbA1c58%. The adjusted hazard ratio for subjects with low-normal UACR/HbA1c48%, high-normal UACR/HbA1c58%, and high-normal UACR/HbA1c 48% were 2.59 (p ¼ 0.107), 6.15 (p ¼ 0.001), and 16.96 (p50.001), respectively. It was determined that an increase of HbA1c levels (58, 8-9, 9-10, 410%) showed a progressively increase of the hazard risk in baseline high-normal UACR group. But the same correlation was not shown in the low-normal UACR group. This study identified the relationships of highnormal albuminuria and glycemic control on microalbuminuria development among T2D patients. Glycemic control is especially beneficial for T2D patients with baseline high-normal UACR in preventing microalbuminuria development.

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“…1,2 Approximately 40% of all diabetic patients develop DN, 3 which is the most common diagnosis among individuals in renal replacement programs, accounting for up to 44% of cases. 4 In Brazil, in 2010, 27.5% of patients on dialysis had DN, and it is likely that in the coming years a significant increase in the number of diabetic patients undergoing dialysis therapy occurs.…”

Section: Introductionmentioning

confidence: 99%

Estimated glomerular filtration rate in patients with type 2 diabetes mellitus

Fontela¹,

Winkelmann²,

Ott

et al. 2014

Rev. Assoc. Med. Bras.

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Objective: to estimate the glomerular filtration using the Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, and serum creatinine in the screening of reduced renal function in patients with type two diabetes (T2DM) enrolled in the Family Health Strategy (ESF, Brazilian federal healthcare program). Methods: a cross-sectional descriptive and analytical study was conducted. The protocol consisted of sociodemographics, physical examination and biochemical tests. Renal function was analyzed through serum creatinine and glomerular filtration rate (GFR) estimated according to the CG, MDRD and CKD-EPI equations, available on the websites of the Brazilian Nephrology Society (SBN) and the (NKF). Results: 146 patients aged 60.9±8.9 years were evaluated; 64.4% were women. The prevalence of serum creatinine >1.2 mg/dL was 18.5% and GFR <60 mL/min/1.73m² totaled 25.3, 36.3 and 34.2% when evaluated by the equations CG, MDRD and CKD-EPI, respectively. Diabetic patients with reduced renal function were older, had long-term T2DM diagnosis, higher systolic blood pressure and higher levels of fasting glucose, compared to diabetics with normal renal function. Creatinine showed strong negative correlation with the glomerular filtration rate estimated using CG, MDRD and CKD-EPI (-0.64, -0.87, -0.89) equations, respectively. Conclusion: the prevalence of individuals with reduced renal function based on serum creatinine was lower, reinforcing the need to follow the recommendations of the SBN and the National Kidney Disease Education Program (NKDEP) in estimating the value of the glomerular filtration rate as a complement to the results of serum creatinine to better assess the renal function of patients.

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High‐normal levels of albuminuria predict the development of micro‐ and macroalbuminuria and increased mortality in Brazilian Type 2 diabetic patients: an 8‐year follow‐up study

Abstract: In normoalbuminuric Type 2 DM patients, the development of micro- or macroalbuminuria and mortality rates was independently and positively associated with higher levels of albuminuria, although still in the traditionally established normal range.

Cited by 37 publications

References 32 publications

Availability of urinary albumin measurement in Southern Brazilian Laboratories

Availability of urinary albumin measurement in Southern Brazilian Laboratories

Effect of glycemic control on microalbuminuria development among type 2 diabetes with high-normal albuminuria

Estimated glomerular filtration rate in patients with type 2 diabetes mellitus

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