To evaluate the potential risk factors for the progression of albuminuria in type II diabetes.
A cohort of 481 type II diabetic patients were followed prospectively for 5 years. Blood glucose (BG) and blood pressure (BP) were checkedat 2 monthly intervals, and urinary albumin excretion (UAE) was checked at yearly intervals. Progression of albuminuria was recognized by the development of microalbuminuria and macroalbuminuria and a significant increase in albuminuria within the microalbuminuric range.
UAE was normal in 349 patients, 93 patients were microalbuminuric, and the rest (39) were macroalbuminuric. Sixty-two patients with normal UAE developed microalbuminuria. Ten patients with normoalbuminuria and 23 with microalbuminuria developed macroalbuminuria during the 5-year observation period with overall incidence of 46.9/1,000 person-years for normoalbuminuria and 58.7/1,000 person-years for microalbuminuria.
Baseline UAE was significantly higher in those patients who progressed compared with those patients who did not (normoalbuminuria: 8.5 ± 6 vs. 5.3 ± 4 μg/min, P < 0.001; microalbuminuria: 68.5 ± 57 vs. 47.4 ± 34 μg/min, P < 0.01). Multiple regression analysis revealed initial UAE and diabetes durationto be predictors of albuminuria progression.
Initial UAE is a strong predictor of albuminuria progression intype II diabetic patients.
