Variability of urinary albumin excretion in patients with microalbuminuria.

Abstract:

OBJECTIVE:To estimate the within-person variability (SDi) for the overnight urinary albumin excretion rate (AER) in diabetic patients with persistent microalbuminuria. RESEARCH DESIGN AND METHODS:Thirteen normotensive diabetic patients in stable medical control, with normal renal function and without any associated cardiovascular or other clinical disorders, collected overnight urines at monthly intervals during one year. AER was determined by radioimmunoassay. RESULTS:Analysis of individual series of AER showed a significant trend (P < or = 0.01) in three cases. The remaining patients (eight men, two women; seven with insulin-dependent diabetes mellitus) had a median mean AER 102 micrograms/min (range 30-238 micrograms/min). Because the individual mean AERs were significantly associated with their respective SDis, the data was loge transformed. LogeSDi was estimated as 0.420, and its 90% probability range (0.353-0.490) was calculated using the bootstrap method. CONCLUSIONS:The high within-person variance for AER means that only people with an initial AER in the range of 53-76 micrograms/min have a high probability (P > or = 0.95) of being classified as microalbuminuric (20-200 micrograms/min) on a subsequent specimen. However, subjects with an initial AER > or = 53 or > or = 80 micrograms/min have a 95 and 99% probability of persistent microalbuminuria. The large variability of AER limits its potential as a serial marker to detect any gradual deterioration of established renal dysfunction.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Phillipou G,Phillips PJ

doi

10.2337/diacare.17.5.425

subject

Has Abstract

pub_date

1994-05-01 00:00:00

pages

425-7

issue

5

eissn

0149-5992

issn

1935-5548

journal_volume

17

pub_type

临床试验,杂志文章,多中心研究,随机对照试验
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