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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 | URI: | https://ahro.austin.org.au/austinjspui/handle/1/13481 | Journal: | Kidney International | URL: | https://pubmed.ncbi.nlm.nih.gov/8872965 | Type: | Journal Article | Subjects: | Adolescent Adult Albuminuria.blood Child Child, Preschool Cohort Studies Cross-Sectional Studies Diabetes Mellitus, Type 1.blood.complications.urine Diabetic Nephropathies.blood Diabetic Retinopathy.blood Disease Progression Female Follow-Up Studies Humans Immunoradiometric Assay Longitudinal Studies Male Predictive Value of Tests Renin.blood Sensitivity and Specificity |
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