Higher levels of Urinary Albumin Excretion within the Normal Range Predict Faster Decline in Glomerular Filtration Rate in Diabetic Patients
- Tetsuya Babazono, MD, PhD (babazono{at}dmc.twmu.ac.jp)1,2,
- 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
- 1the Division of Nephrology and Hypertension and
- 2Department of Medicine, Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo 162-8666, Japan
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: 5,449 Japanese diabetic patients were categorized according to gender 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 genders. 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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- Received December 4, 2008.
- Accepted May 3, 2009.
- Copyright © American Diabetes Association
