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|Title:||Nonalbuminuric renal insufficiency in type 2 diabetes.|
|Authors:||MacIsaac, Richard J;Tsalamandris, Con;Panagiotopoulos, Sianna;Smith, Trudy J;McNeil, Karen J;Jerums, George|
|Affiliation:||Endocrinology Unit, Austin Health, Heidelberg, Victoria, Australia|
|Citation:||Diabetes Care; 27(1): 195-200|
|Abstract:||To determine the prevalence and characteristics of patients with type 2 diabetes who have impaired renal function, defined as a glomerular filtration rate (GFR) <60 ml. min(-1). 1.73 m(-2), and normoalbuminuria.A cross-sectional survey of 301 outpatients attending a single tertiary referral center using the plasma disappearance of isotopic (99m)Tc-diethylene-triamine-penta-acetic acid to measure GFR and at least two measurements of urinary albumin excretion rate (AER) over 24 h to determine albuminuria.A total of 109 patients (36%) had a GFR <60 ml. min(-1). 1.73 m(-2). The overall prevalence of normo-, micro-, and macroalbuminuria was 43 of 109 (39%), 38 of 109 (35%), and 28 of 109 (26%), respectively. Compared with patients with macroalbuminuria, those with normoalbuminuria were more likely to be older and female. After excluding patients whose normoalbuminuric status was possibly related to the initiation of a renin-angiotensin system (RAS) inhibitor before the start of the study, the prevalence of a GFR <60 ml. min(-1). 1.73 m(-2) and normoalbuminuria was 23%. Temporal changes in GFR in a subset of 34 of 109 (32%) unselected patients with impaired renal function were available for comparison over a 3- to 10-year period. The rates of decline in GFR (ml. min(-1). 1.73 m(-2). year(-1)) of -4.6 +/- 1.0, -2.8 +/- 1.0, and -3.0 +/- 07 were not significantly different for normo- (n = 12), micro- (n = 12), and macroalbuminuric (n = 10) patients, respectively.These results suggest that patients with type 2 diabetes can commonly progress to a significant degree of renal impairment while remaining normoalbuminuric.|
|Internal ID Number:||14693989|
|Subjects:||Age of Onset|
Diabetes Mellitus, Type 2.urine
Glomerular Filtration Rate.physiology
Kidney Failure, Chronic.urine
|Appears in Collections:||Journal articles|
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