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Risk markers of future microalbuminuria and hypertension based on clinical and morphological parameters in young type 1 diabetes patients
Author(s) -
Perrin Nina ESS,
Torbjörnsdotter T,
Jaremko Georg A,
Berg Ulla B
Publication year - 2010
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-5448.2009.00595.x
Subject(s) - microalbuminuria , medicine , diabetes mellitus , albuminuria , type 2 diabetes , cardiology , endocrinology
Perrin NESS, Torbjörnsdotter T, Jaremko GA, Berg UB. Risk markers of future microalbuminuria and hypertension based on clinical and morphological parameters in young type 1 diabetes patients. Background: Nephropathy is a severe complication of type 1 diabetes and develops in 30% of patients. Currently, it is not possible to identify young patients at risk prior to the development of microalbuminuria (MA) and/or hypertension (HT). Objective: To study predictors of MA and/or HT in young normoalbuminuric (NA) patients with type 1 diabetes. Subjects and methods: Forty‐six NA and normotensive (NT) type 1 diabetes patients, regularly followed since onset with checks on metabolic control, kidney function, and MA, were investigated with kidney biopsies and 24‐h ambulatory blood pressure measurements (ABPMs) after 10.6 yr of diabetes. The patients were followed another six and a half years with regard to the development of MA and HT. Results: Fifteen patients developed MA and/or HT during follow‐up. The strongest risk markers were poor metabolic control after puberty, high day‐time systolic blood pressure (BP), and increased BMT at 10 yr, which explained 62% of the outcome for MA and/or HT at 17 yr duration with 77% sensitivity and 65% specificity. The threshold values were long‐term postpubertal HbA 1c > 8.2%, day‐time systolic BP > 130 mmHg, and BMT > 490 nm/1.73 m 2 . Conclusions: Normoalbuminuric and NT patients at risk of developing MA and HT could be identified and might benefit from an early start of antihypertensive therapy and improvement of metabolic control.