ISSN:
1432-0428
Keywords:
Key words Non-insulin-dependent diabetes mellitus
;
albuminuria
;
blood pressure
;
rate of progression
;
progressors
;
glycaemic control.
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary We prospectively followed a cohort of 278 non-insulin-dependent (NIDDM) patients for a 6-year period, intending to estimate the rate of increase of albuminuria and to identify clinical variables that influence this increase. At baseline, normoalbuminuria (N) was seen in 74 %, microalbuminuria (M) in 19 % and 7 % presented with proteinuria (P). A total of 80 patients died; they were older (p 〈 0.001) and had higher albumin excretion both at baseline and as an average during follow-up (p 〈 0.01). At baseline, patients with proteinuria had higher blood pressures (systolic and diastolic), whereas there was no difference between patients with normo- and microalbuminuria. Glycaemic control was increasingly poor throughout the three groups. At follow-up, an average relative rate of increase of albuminuria (slope) of 17 % per year was seen both for patients with complete 6 years, follow-up (n = 135) and patients with at least 4 years follow-up (n = 178). Slope correlated significantly with systolic blood pressure (r = 0.26 and 0.29) in both groups, diastolic blood pressure only in the 4-year group (r = 0.22) and average albuminuria in both (r = 0.31 and 0.24). By multiple regression analyses systolic blood pressure and average albuminuria remained with significant influence on slope. Progression was defined as an increase in the category (e. g. normo- to microalbuminuria) as well as an increase of more than 20 % in albumin excretion, and was seen in 46 patients with at least 4 years' follow-up. Progressors (patients demonstrating progression) had higher systolic blood pressure (165 mm Hg ± 20 vs 156 ± 17) and poorer glycaemic control (HbA1C: 8.2 % ± 1.5 vs 7.7 ± 1.3) p 〈 0.05, as well as a higher level of albuminuria at baseline. The present study points to systolic blood pressure and general level of albuminuria as factors determining the rate of progression of albuminuria. However, only a modest fraction of the variation between subjects was explained by these variables. [Diabetologia (1994) 37: 1251–1258]
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00399799
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