RATE OF PROGRESSION OF ALBUMINURIA IN TYPE-II DIABETES - 5-YEAR PROSPECTIVE-STUDY FROM SOUTH-INDIA

OBJECTIVE - To evaluate the potential risk factors for the progression of albuminuria in type II diabetes. RESEARCH DESIGN AND METHODS - A c ohort of 481 type II diabetic patients were followed prospectively for 5 years. Blood glucose (BG) and blood pressure (BP) were checked at 2 monthly intervals, and urinary albumin excretion (UAE) was checked at yearly intervals. Progression of albuminuria was recognized by the de velopment of microalbuminuria and macroalbuminuria and a significant i ncrease in albuminuria within the mitroalbuminuric range. RESULTS - UA E was normal in 349 patients, 93 patients were microalbuminuric, and t he rest (39) were macroalbuminuric. Sixty-two patients with normal UAE developed microalbuminuria. Ten patients with normoalbuminuria and 23 with microalbuminuria developed macroalbuminuria during the 5-year ob servation period with overall incidence of 46.9/1,000 person-years for normoalbuminuria and 58.7/1,000 person-years for microalbuminuria. Ba seline UAE was significantly higher in those patients who progressed c ompared with those patients who did not (normoalbuminuria: 8.5 +/- 6 v s. 5.3 +/- 4 mu g/min, P < 0.001; microalbuminuria: 68.5 +/- 57 vs. 47 .4 +/- 34 mu g/min, P < 0.01). Multiple regression analysis revealed i nitial UAE and diabetes duration to be predictors of albuminuria progr ession. CONCLUSIONS - Initial UAE is a strong predictor of albuminuria progression in type II diabetic patients.