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Normoalbuminuria ensures no reduction of renal function in type 1 (insulin‐dependent) diabetic patients
Author(s) -
HANSEN K. W.,
PEDERSEN M. MAU,
CHRISTENSEN C. K.,
SCHMITZ A.,
CHRISTIANSEN J. S.,
MOGENSEN C. E.
Publication year - 1992
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1992.tb00566.x
Subject(s) - medicine , renal function , urology , diabetes mellitus , blood pressure , type 2 diabetes , endocrinology
Recent reports have suggested that impaired renal function in type 1 diabetic patients may be present despite normal urinary albumin excretion (UAE). We have studied kidney function by means of a constant‐infusion technique in normoalbuminuric type 1 diabetic patients without antihypertensive medication (UAE < 20 μg min −1 , n = 134), in microalbuminuric patients (20 ≥ UAE < 200 μg min −1 , n = 50) and in 27 non‐diabetic control subjects. Mean UAE was 4.5 μg min −1 (range 1.0–19.3 μg min −1 ) in normoalbuminuric patients, 53.1 μg min −1 (range 20.8–147.5 μg min −1 ) in microalbuminuric patients, and 4.0 μg min −1 (range 2.1–17.9 μg min −1 ) in controls. Glycosylated haemoglobin A 1c was significantly higher in microalbuminuric patients (8.9%, range 5.9–12.6%) than in normoalbuminuric patients (7.9%, range 5.5–11.5%) ( P < 0.0001). Glomerular filtration rate in normoalbuminuric patients (135 ml min −1 , range 97–198 ml min −1 ) was significantly higher than in controls (118 ml min −1 , range 94–139 ml min −1 ) ( P < 1 times 10 −6 ), and significantly lower than in microalbuminuric patients (142 ml min −1 , range 100–186 ml min −1 ) ( P < 0.05). Mean arterial blood pressure was lower in normoalbuminuric patients (91 mmHg, range 78–108 mmHg) than in microalbuminuric patients (98 mmHg, range 82–131 mmHg) ( P < 1 times 10 −6 ), but not significantly different from that of controls (89 mmHg, range 73–103 mmHg). We conclude that normal UAE is a reliable indicator of well‐preserved renal function. Glomerular hyperfiltration, elevated blood pressure and poor metabolic control are characteristic features of microalbuminuric patients.