Higher Levels of Urinary Albumin Excretion Within the Normal Range Predict Faster Decline in Glomerular Filtration Rate in Diabetic Patients
- Tetsuya Babazono, MD, PHD1,2,
- Izumi Nyumura, MD1,2,
- Kiwako Toya, MD1,2,
- Toshihide Hayashi, MD, PHD1,2,
- Mari Ohta, MD1,2,
- Kumi Suzuki, MD1,2,
- Yuka Kiuchi, MD1,2 and
- Yasuhiko Iwamoto, MD, PHD1
- 1Division of Nephrology and Hypertension, Tokyo Women's Medical University School of Medicine, Tokyo, Japan;
- 2Department of Medicine, Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
- Corresponding author: Tetsuya Babazono, babazono{at}dmc.twmu.ac.jp.
Abstract
OBJECTIVE To assess the relationship between albuminuria, including elevation within the normal range, and decline in glomerular filtration rate (GFR) in diabetic patients.
RESEARCH DESIGN AND METHODS A total of 5,449 Japanese diabetic patients were categorized according to sex and urinary albumin-to-creatinine ratio (ACR; <5, 5–9, 10–29, 30–99, 100–299, 300–999, 1,000–2,999, and ≥3,000 mg/g) and followed for at least 5 years. The rate of change in estimated GFR (eGFR) adjusted for age and baseline eGFR was compared among ACR categories.
RESULTS A higher baseline ACR predicted a faster decline in eGFR for both sexes. Even within the normal range (<30 mg/g), ACR ≥10 mg/g in women and ≥5 mg/g in men was associated with a significantly greater rate of decline in eGFR relative to subjects with ACR <5 mg/g.
CONCLUSIONS Elevated ACR, even within the normal range, is associated with a faster decline in eGFR in diabetic patients.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received December 4, 2008.
- Accepted May 3, 2009.
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Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
- © 2009 by the American Diabetes Association.
