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Title: Serum total renin is increased before microalbuminuria in diabetes.
Austin Authors: Allen, Terri J;Cooper, Mark E;Gilbert, Richard E;Winikoff, J;Skinni, S L;Jerums, George 
Affiliation: Department of Medicine, University of Melbourne, Austin & Repatriation Medical Centere, Heidelberg, Victoria, Australia
Issue Date: 1-Sep-1996
Publication information: Kidney International; 50(3): 902-7
Abstract: Serum prorenin is increased in patients with insulin dependent diabetes mellitus (IDDM) with microvascular complications. The present longitudinal study investigated whether increases in serum total renin concentration (TRC, active+prorenin) can predict the development of microalbuminuria in IDDM patients over a 10 year period. TRC and albumin excretion rates (AER) were determined in 78 IDDM patients who were followed longitudinally for 10.4 +/- 0.2 (mean +/- SE) years. Twelve patients had progressively increasing albuminuria (progressors), and these were compared to 66 patients in whom albuminuria did not rise (non-progressors). The two groups had similar duration of diabetes, age, follow-up, glycemic control and blood pressure at the start of the study. Serum TRC was increased in progressors [350 (1.1) mIU/liter, geometric mean (tolerance factor)] compared to non-progressors [189 (1.2)] after 5 to 10 years duration of diabetes, and continued to rise in this group, reaching a mean of 923 mIU/liter (normal range 131 to 170) after 20 years of diabetes. When serial measurements of TRC and AER were compared in individual progressors, a significant increase in TRC was apparent up to five years before the onset of microalbuminuria. Microalbuminuria in patients with IDDM is preceded by a substantial increase in serum TRC, suggesting that serum TRC may predict the subsequent development of incipient nephropathy.
Gov't Doc #: 8872965
Journal: Kidney International
Type: Journal Article
Subjects: Adolescent
Child, Preschool
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus, Type 1.blood.complications.urine
Diabetic Nephropathies.blood
Diabetic Retinopathy.blood
Disease Progression
Follow-Up Studies
Immunoradiometric Assay
Longitudinal Studies
Predictive Value of Tests
Sensitivity and Specificity
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