Predictive Value of Albuminuria in American Indian Youth With or Without Type 2 Diabetes
- Authors
- Kim, Nan Hee; Pavkov, Meda E.; Knowler, William C.; Hanson, Robert L.; Weil, E. Jennifer; Curtis, Jeffrey M.; Bennett, Peter H.; Nelson, Robert G.
- Issue Date
- 4월-2010
- Publisher
- AMER ACAD PEDIATRICS
- Keywords
- diabetic nephropathy; epidemiology; incidence; longitudinal; prevalence; risk factors
- Citation
- PEDIATRICS, v.125, no.4, pp.E844 - E851
- Indexed
- SCIE
SCOPUS
- Journal Title
- PEDIATRICS
- Volume
- 125
- Number
- 4
- Start Page
- E844
- End Page
- E851
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/116721
- DOI
- 10.1542/peds.2009-1230
- ISSN
- 0031-4005
- Abstract
- OBJECTIVE: To examine the prognostic significance of elevated albuminuria 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 macroalbuminuria (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% confidence interval: 11.1-22.6) higher in the diabetic than in the nondiabetic youth. CONCLUSIONS: Elevated albuminuria is infrequent and largely transient in nondiabetic youth, but it is relatively frequent and largely persistent in those with diabetes. Microalbuminuria in youth with type 2 diabetes strongly predicts progression to macroalbuminuria, which supports annual screening for albuminuria. Pediatrics 2010; 125: e844-e851
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