ESTIMATED URINARY ALBUMIN INDEX - A PREDICTOR OF MICROALBUMINURIA IN TYPE-2 DIABETES

This study examined factors contributing to the development of microal buminuria in diabetic patients. A total of 236 patients with Type 2 di abetes were studied: 143 were normoalbuminuric and 86 were also normot ensive. Multiple regression analysis was used to identify factors infl uencing the urinary albumin index (UAI), an index of proteinuria based on urinary albumin adjusted for urinary creatinine. Significant facto rs (retinopathy, systolic blood pressure, and glycosylated haemoglobin ) were used to generate a formula for estimating the log(e) UAI. Targe t values for systolic blood pressure and glycosylated haemoglobin to m aintain the urinary albumin index at or below 22 were determined for d ifferent degrees of retinopathy. Normoalbuminuric patients were follow ed for 3 years to evaluate their progression to microalbuminuria. Each month, blood pressure, urinary albumin and creatinine, and glycosylat ed haemoglobin were measured. In normotensive, normoalbuminuric patien ts, initial urinary albumin index and log(e) UAI were significantly hi gher in patients who subsequently developed microalbuminuria. Patients with initial log(e) UAI > 3.09 or initial glycosylated haemoglobin > 6.0% also showed greater progression to microalbuminuria. Hyperglycaem ia was an independent factor for the development of microalbuminuria i n Type 2 diabetes. The urinary albumin index was most significantly af fected by retinopathy, systolic blood pressure, and glycosylated haemo globin. The estimated log(e) UAI calculated from these factors is a us eful predictor of progression to microalbuminuria.