Titre du document / Document title

Risk factors for development of incipient and overt diabetic nephropathy in type 1 diabetic patients: A 10-year prospective observational study

Auteur(s) / Author(s)

ROSSING Peter ⁽¹⁾ ; HOUGAARD Philip ⁽²⁾ ; PARVING Hans-Henrik ⁽³⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Steno Diabetes Center, Gentofte, DANEMARK
⁽²⁾ Novo Nordisk, Biostatistics, Bagsvaerd, DANEMARK
⁽³⁾ Faculty of Health Science, University of Aarhus, DANEMARK

Résumé / Abstract

OBJECTIVE - To evaluate prospectively putative risk factors for development of microalbuminuria and macroalbuminuria in type 1 diabetes. RESEARCH DESIGN AND METHODS - Prospective observational study of a cohort of type 1 diabetic patients followed in the outpatient clinic at Steno Diabetes Center for ≤10 years (median 9 years). We followed 537 patients aged ≥18 years with type 1 diabetes, with duration of diabetes ≥5 years, with normoalbuminuria (urinary albumin excretion rate ≤30 mg/24 h), and who were not taking antihypertensive medication. Risk factors for development of microalbuminuria and macroalbuminuria were evaluated RESULTS - The mean progression of urinary albumin excretion rate was 7.6% (SE 0.8) per year. During follow-up, 134 patients (25%) progressed to persistent microalbuminuria or macroalbuminuria (>30 mg/24 h in two of three consecutive urine samples). Cox multiple regression analysis using baseline values of putative predictors of progression showed the following significant predictors of progression from normoalbuminuria to microalbuminuria or macroalbuminuria: baseline log urinary albumin excretion rate 2.63 (relative risk; 95% CI 1.65-4.19), HbA_1c 1.13% (1.04-1.23), presence of any retinopathy 1.90 (1.26-2.88), and smoking 1.61 (1.11-2.33). Sex, duration of diabetes, arterial blood pressure, serum creatinine, height and social class were not risk factors CONCLUSIONS - Our study suggests that several potentially modifiable risk factors predict the development of microalbuminuria and macroalbuminuria in type 1 diabetic patients.

Revue / Journal Title

Diabetes care   ISSN 0149-5992   CODEN DICAD2 

Source / Source

2002, vol. 25, n^o5, pp. 859-864 (27 ref.)

Langue / Language

Anglais

Editeur / Publisher

American Diabetes Association, Alexandria, VA, ETATS-UNIS  (1978) (Revue)

Mots-clés anglais / English Keywords

Eye disease ; Proteinuria ; Urinary system disease ; Kidney disease ; Endocrinopathy ; Autoimmune disease ; Immunopathology ; Antihypertensive agent ; Excretion ; Albumin ; Urine ; Ambulatory ; Microalbuminuria ; Human ; Risk factor ; Regression analysis ; Multiple ; Sample ; Cohort study ; Tobacco smoking ; Blood pressure ; Arterial pressure ; Retinopathy ; Nephropathy ; Insulin dependent diabetes ;

Mots-clés français / French Keywords

Oeil pathologie ; Protéinurie ; Appareil urinaire pathologie ; Rein pathologie ; Endocrinopathie ; Maladie autoimmune ; Immunopathologie ; Antihypertenseur ; Excrétion ; Albumine ; Urine ; Ambulatoire ; Microalbuminurie ; Homme ; Facteur risque ; Analyse régression ; Multiple ; Echantillon ; Etude cohorte ; Tabagisme ; Pression sanguine ; Pression artérielle ; Rétinopathie ; Néphropathie ; Diabète insulinodépendant ;

Mots-clés espagnols / Spanish Keywords

Ojo patología ; Proteinuria ; Aparato urinario patología ; Riñón patología ; Endocrinopatía ; Enfermedad autoinmune ; Inmunopatología ; Antihipertensivo ; Excreción ; Albúmina ; Orina ; Ambulatorio ; Microalbuminuria ; Hombre ; Factor riesgo ; Análisis regresión ; Múltiple ; Muestra ; Estudio cohorte ; Tabaquismo ; Presión sanguínea ; Presión arterial ; Retinopatía ; Nefropatía ; Diabetes insulinodependiente ;

Localisation / Location

INIST-CNRS, Cote INIST : 18054, 35400010825199.0090