Diabetes Care, Vol 17, Issue 8 888-890, Copyright © 1994 by American Diabetes Association

ARTICLES

Rate of progression of albuminuria in type II diabetes. Five-year prospective study from south India

L John, PS Rao and AS Kanagasabapathy
Department of Medicine, Biostatistics and Clinical Biochemistry, Christian Medical College and Hospital, Vellore, India.

OBJECTIVE--To evaluate the potential risk factors for the progression of albuminuria in type II diabetes. RESEARCH DESIGN AND METHODS--A cohort of 481 type II diabetic patients were followed prospectively for 5 years. Blood glucose (BG) and blood pressure (BP) were checked at 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. RESULTS--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 micrograms/min, P < 0.001; microalbuminuria: 68.5 +/- 57 vs. 47.4 +/- 34 micrograms/min, P < 0.01). Multiple regression analysis revealed initial UAE and diabetes duration to be predictors of albuminuria progression. CONCLUSIONS--Initial UAE is a strong predictor of albuminuria progression in type II diabetic patients.
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