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An examination of the covariability of subclinical albuminuria in insulin-dependent diabetes mellitus: implications for monitoring microalbuminuria.

Abstract：

:We examined the covariability of subclinical albuminuria in a cohort of 160 insulin-dependent diabetics who underwent simultaneous measurements of overnight urinary albumin excretion rate (UAV) and several clinical variables on 7 occasions over a period of 18 months. After allowing for within-patient correlation between visits, significant within-patient associations were found between UAV and variations in tobacco consumption (regression coefficient = 0.006, S.E. = 0.002, P = 0.02), insulin dose (regression coefficient = 0.003, S.E. = 0.001, P = 0.01) and creatinine clearance (regression coefficient = 0.776, S.E. = 0.047, P < 0.0001); the association between UAV and creatinine clearance was not influenced by adjusting for urine flow rate. No significant associations were found between UAV and changes in blood pressure, glycaemic control or other variables. We then focused on 33 patients with intermittent microalbuminuria, defined as a UAV > 30 micrograms/min on at least one occasion, but not exceeding 3 consecutive occasions. These patients had a total of 52 episodes of microalbuminuria which were significantly associated at the 5% level with increases in creatinine clearance (P = 0.02), but not with changes in other variables. Our findings did not differ in patients with intermittent microalbuminuria defined with reference to a cut-off UAV of 20 micrograms/min. We conclude that changes in glomerular filtration rate (as reflected by creatinine clearance) may partly account for the within-patient variability in subclinical albuminuria in insulin-dependent diabetics, and that variables routinely measured in the clinic are not useful for deciding when to monitor patients for microalbuminuria.

journal_name

Diabetes Res Clin Pract

journal_title

Diabetes research and clinical practice

authors

Watts GF,Taub NA,Mazurkiewicz J,Shaw KM

doi

10.1016/0168-8227(93)90067-f

subject

Has Abstract

pub_date

1993-08-01 00:00:00

pages

177-85

issue

2-3

eissn

0168-8227

issn

1872-8227

pii

0168-8227(93)90067-F

journal_volume

pub_type

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An examination of the covariability of subclinical albuminuria in insulin-dependent diabetes mellitus: implications for monitoring microalbuminuria.