Plasma prorenin levels may predict persistent microalbuminuria in childrenwith diabetes

Diabetic microangiopathy is characterized by increased prorenin concentrati ons. In the present study, we evaluated plasma prorenin concentrations in a large group of adolescents with onset of diabetes during childhood to dete rmine whether increasing prorenin levels may predict the development of per sistent microalbuminuria. Ninety-seven young diabetic patients were studied ; they were divided according to the presence of persistent microalbuminuri a, at the end of follow-up, into group A and group B (patients who did not develop and who developed persistent microalbuminuria, respectively). One h undred and two healthy subjects, matched for age and sex, were also selecte d. Patients were followed up for at least 10 years. At the beginning of the study there were no significant differences in prorenin levels between eit her the two diabetic groups or the healthy controls. During follow-up, an i ncrease in plasma prorenin started at 4 years and became statistically sign ificant (P<0.01) 3 years before the onset of persistent microalbuminuria. N o correlation was found between plasma prorenin levels and HbA1c percentage s. In conclusion, an increased concentration of prorenin in plasma precedes the elevation of albumin excretion rate (AER) and, therefore, can be usefu l for identifying patients with onset of diabetes during childhood at risk of developing incipient nephropathy later in life.