open access

Vol 8, No 10 (2007): Practical Diabetology
Original articles (translated)
Published online: 2008-02-01
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Reduction in microalbuminuria as an integrated indicator for renal and cardiovascular risk reduction in patients

Shin-ichi Araki, Masakazu Haneda, Daisuke Koya, Hideki Hidaka, Toshiro Sugimoto, Motohide Isono, Keiji Isshiki, Masami Chin-Kanasaki, Takashi Uzu, Atsunori Kashiwagi
Diabetologia Praktyczna 2007;8(10):379-385.

open access

Vol 8, No 10 (2007): Practical Diabetology
Original articles (translated)
Published online: 2008-02-01

Abstract

OBJECTIVE. Microalbuminuria in diabetic patients is a predictor for diabetic nephropathy and cardiovascular disease. The aim of this study is to investigate the clinical impact of reducing microalbuminuria in type 2 diabetic patients in an observational follow-up study.
RESEARCH DESIGN AND METHODS. We enrolled 216 type 2 diabetic patients with microalbuminuria during an initial 2-year evaluation period and observed them for the next 8 years. Remission and a 50% reduction of microalbuminuria were defined as a shift to normoalbuminuria and a reduction < 50% from the initial level of microalbuminuria. The association between reducing microalbuminuria and first occurrence of a renal or cardiovascular event and annual decline rate of estimated glomerular filtration rate (eGFR) was evaluated.
RESULTS. Twelve events occurred in 93 patients who attained a 50% reduction of microalbuminuria during the follow-up versus 35 events in 123 patients without a 50% reduction. The cumulative incidence rate of events was significantly lower in patients with a 50% reduction. A pooled logistic regression analysis revealed that the adjusted risk for events in subjects after a 50% reduction was 0.41 (95% CI: 0.15-0.96). In addition, the annual decline rate of eGFR in patients with a 50% reduction was significantly slower than in those without such a reduction. The same results were also found in the analysis regarding whether remission occurred.
CONCLUSIONS. The present study provides clinical evidence implying that a reduction of microalbuminuria in type 2 diabetic patients is an integrated indicator for renal and cardiovascular risk reduction.

Abstract

OBJECTIVE. Microalbuminuria in diabetic patients is a predictor for diabetic nephropathy and cardiovascular disease. The aim of this study is to investigate the clinical impact of reducing microalbuminuria in type 2 diabetic patients in an observational follow-up study.
RESEARCH DESIGN AND METHODS. We enrolled 216 type 2 diabetic patients with microalbuminuria during an initial 2-year evaluation period and observed them for the next 8 years. Remission and a 50% reduction of microalbuminuria were defined as a shift to normoalbuminuria and a reduction < 50% from the initial level of microalbuminuria. The association between reducing microalbuminuria and first occurrence of a renal or cardiovascular event and annual decline rate of estimated glomerular filtration rate (eGFR) was evaluated.
RESULTS. Twelve events occurred in 93 patients who attained a 50% reduction of microalbuminuria during the follow-up versus 35 events in 123 patients without a 50% reduction. The cumulative incidence rate of events was significantly lower in patients with a 50% reduction. A pooled logistic regression analysis revealed that the adjusted risk for events in subjects after a 50% reduction was 0.41 (95% CI: 0.15-0.96). In addition, the annual decline rate of eGFR in patients with a 50% reduction was significantly slower than in those without such a reduction. The same results were also found in the analysis regarding whether remission occurred.
CONCLUSIONS. The present study provides clinical evidence implying that a reduction of microalbuminuria in type 2 diabetic patients is an integrated indicator for renal and cardiovascular risk reduction.
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About this article
Title

Reduction in microalbuminuria as an integrated indicator for renal and cardiovascular risk reduction in patients

Journal

Clinical Diabetology

Issue

Vol 8, No 10 (2007): Practical Diabetology

Pages

379-385

Published online

2008-02-01

Bibliographic record

Diabetologia Praktyczna 2007;8(10):379-385.

Authors

Shin-ichi Araki
Masakazu Haneda
Daisuke Koya
Hideki Hidaka
Toshiro Sugimoto
Motohide Isono
Keiji Isshiki
Masami Chin-Kanasaki
Takashi Uzu
Atsunori Kashiwagi

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