Rate of Progression of Albuminuria in Type II Diabetes: Five-year prospective study from South India
- Lily John, MD,
- P S S Sunder and
- AS Kanagasabapathy, PHD
- Department of Medicine, Biostatistics and Clinical Biochemistry, Christian Medical College and Hospital Vellore, India
- Address correspondence and reprint requests to Lily John, MD, the Department of Medicine, Christian Medical College and Hospital, Vellore 632 004, India.
Abstract
OBJECTIVE To evaluate the potential risk factors for the progression of albuminuria in type II diabetes.
RESEARCH DESIGN AND METHODS A cohort of 481 type II diabetic patients were followed prospectively for 5 years. Blood glucose (BG) and blood pressure (BP) were checkedat 2 monthly intervals, and urinary albumin excretion (UAE) was checked at yearly intervals. Progression of albuminuria was recognized by the development of microalbuminuria and macroalbuminuria and a significant increase in albuminuria within the microalbuminuric range.
RESULTS UAE was normal in 349 patients, 93 patients were microalbuminuric, and the rest (39) were macroalbuminuric. Sixty-two patients with normal UAE developed microalbuminuria. Ten patients with normoalbuminuria and 23 with microalbuminuria developed macroalbuminuria during the 5-year observation period with overall incidence of 46.9/1,000 person-years for normoalbuminuria and 58.7/1,000 person-years for microalbuminuria.
Baseline UAE was significantly higher in those patients who progressed compared with those patients who did not (normoalbuminuria: 8.5 ± 6 vs. 5.3 ± 4 μg/min, P < 0.001; microalbuminuria: 68.5 ± 57 vs. 47.4 ± 34 μg/min, P < 0.01). Multiple regression analysis revealed initial UAE and diabetes durationto be predictors of albuminuria progression.
CONCLUSIONS Initial UAE is a strong predictor of albuminuria progression intype II diabetic patients.
- Received May 24, 1993.
- Accepted January 27, 1994.
- Copyright © 1994 by the American Diabetes Association
