Predictive value of albuminuria in American Indian youth with or without type 2 diabetes

Nan Hee Kim, Meda E. Pavkov, William C. Knowler, Robert L. Hanson, E. Jennifer Weil, Jeffrey M. Curtis, Peter H. Bennett, Robert G. Nelson

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17 Citations (Scopus)

Abstract

OBJECTIVE: To examine the prognostic significance of elevated albu-minuria in youth with type 2 diabetes. PATIENTS AND METHODS: Cross-sectional and prospective studies were conducted on Pima Indian youth aged 5 to 19 years at baseline who were examined between July 1, 1982, and December 31, 2007. Prevalence and sequential changes in the level of microalbuminuria (30 < albumin-to-creatinine ratio [ACR] < 300 mg/g) and macroalbu-minuria (ACR > 300 mg/g) and incidence of macroalbuminuria were computed according to the presence or absence of type 2 diabetes. RESULTS: The prevalence of microalbuminuria and macroalbuminuria was 6.5% and 0.6% in the 3856 nondiabetic youth and 18.5% and 2.9% in the 103 youth with diabetes, respectively. One hundred forty-one of 187 (75.4%) nondiabetic youth, but only 1 of 14(7.1%)diabetic youth with an elevated ACR (>30 mg/g) regressed to an undetectable or normal ACR (<30 mg/g) on subsequent examination. In a subset of 2666 youth with a median follow-up of 8.1 years, 36 nondiabetic and 30 diabetic youth with baseline ACRs of <300 mg/g developed macroalbuminuria. For a given ACR, the incidence of macroalbuminuria was 15.9-fold (95% con-fidence interval: 11.1-22.6) higher in the diabetic than in the nondia-betic youth. CONCLUSIONS: Elevated albuminuria is infrequent and largely tran-sient in nondiabetic youth, but it is relatively frequent and largely per-sistent in those with diabetes. Microalbuminuria in youth with type 2 diabetes strongly predicts progression to macroalbuminuria, which supports annual screening for albuminuria.

Original languageEnglish
Pages (from-to)e844-e851
JournalPediatrics
Volume125
Issue number4
DOIs
Publication statusPublished - 2010 Apr

Keywords

  • Diabetic nephropathy
  • Epidemiology
  • Iincidence
  • Longitudinal
  • Prevalence
  • Risk factors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Kim, N. H., Pavkov, M. E., Knowler, W. C., Hanson, R. L., Jennifer Weil, E., Curtis, J. M., Bennett, P. H., & Nelson, R. G. (2010). Predictive value of albuminuria in American Indian youth with or without type 2 diabetes. Pediatrics, 125(4), e844-e851. https://doi.org/10.1542/peds.2009-1230