MICROALBUMINURIA - PROGNOSTIC AND THERAPEUTIC IMPLICATIONS IN DIABETES-MELLITUS

Thirty years following the development of the first radioimmunoassay f or albumin, microalbuminuria is widely acknowledged as an important pr edictor of overt nephropathy in patients with Type 1 diabetes and of c ardiovascular mortality in Type 2 diabetes. In addition, there is accu mulating evidence to suggest that diabetic patients with microalbuminu ria may have more advanced retinopathy, higher blood pressure, and wor se dyslipidaemia than patients with normal albumin excretion rates. Re cent studies have focused on the role of intervention, principally wit h antihypertensive therapy and intensive glycaemic control, in reducin g microalbuminuria. While successful in reducing urinary albumin excre tion it remains to be established whether such therapies will be trans lated into a reduction in renal failure and decreased cardiovascular m obidity and mortality.