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 language | English |
|---|---|
| Journal | Pediatrics |
| Volume | 125 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2010 Apr 1 |
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Keywords
- Diabetic nephropathy
- Epidemiology
- Iincidence
- Longitudinal
- Prevalence
- Risk factors
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Predictive value of albuminuria in American Indian youth with or without type 2 diabetes. / Kim, Nan Hee; Pavkov, Meda E.; Knowler, William C.; Hanson, Robert L.; Jennifer Weil, E.; Curtis, Jeffrey M.; Bennett, Peter H.; Nelson, Robert G.
In: Pediatrics, Vol. 125, No. 4, 01.04.2010.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predictive value of albuminuria in American Indian youth with or without type 2 diabetes
AU - Kim, Nan Hee
AU - Pavkov, Meda E.
AU - Knowler, William C.
AU - Hanson, Robert L.
AU - Jennifer Weil, E.
AU - Curtis, Jeffrey M.
AU - Bennett, Peter H.
AU - Nelson, Robert G.
PY - 2010/4/1
Y1 - 2010/4/1
N2 - 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.
AB - 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.
KW - Diabetic nephropathy
KW - Epidemiology
KW - Iincidence
KW - Longitudinal
KW - Prevalence
KW - Risk factors
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UR - http://www.scopus.com/inward/citedby.url?scp=77950565343&partnerID=8YFLogxK
U2 - 10.1542/peds.2009-1230
DO - 10.1542/peds.2009-1230
M3 - Article
VL - 125
JO - Pediatrics
JF - Pediatrics
SN - 0031-4005
IS - 4
ER -