Natural history of nephropathy in type I diabetes. Relationship to metabolic control and blood pressure.

In recent years, the respective roles of metabolic control and blood pressure on the development of nephropathy in patients with type I diabetes have been studied intensively. Based on our own retrospective analysis, we conclude that metabolic control, but not blood pressure, determines the onset of proteinuria in these patients. Once proteinuria has developed, concurrent metabolic control has little effect on the time interval to onset of renal failure. In contrast, blood pressure has great predictive value for the time interval to onset of both renal failure and proliferative retinopathy.