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Title: Nonalbuminuric renal insufficiency in type 2 diabetes.
Austin Authors: MacIsaac, Richard J;Tsalamandris, Con;Panagiotopoulos, Sianna ;Smith, Trudy J;McNeil, Karen J;Jerums, George 
Affiliation: Endocrinology Unit, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 1-Jan-2004
Publication information: 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.
Gov't Doc #: 14693989
ORCID: 0000-0002-0845-0001
Type: Journal Article
Subjects: Age of Onset
Cross-Sectional Studies
Diabetes Mellitus, Type 2.urine
Diabetic Nephropathies.urine
Glomerular Filtration Rate.physiology
Kidney Failure, Chronic.urine
Appears in Collections:Journal articles

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