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Preventing diabetic nephropathy: an audit
- Source :
- Scandinavian journal of clinical and laboratory investigation. 61(6)
- Publication Year :
- 2001
-
Abstract
- In type 1 diabetic patients with microalbuminuria not receiving antihypertensive treatment, an increase in urinary albumin excretion rate (AER) of 6% to 14%/year and a risk for the development of diabetic nephropathy of 3% to 30%/year have previously been reported. The aim of the present study was to audit the effect of angiotensin converting enzyme (ACE) inhibition on the progression of microalbuminuria and development of diabetic nephropathy. We consecutively identified 227 type 1 diabetic patients with persistent microalbuminuria (urinary AER between 30 and 300mg/24h, ELISA). According to the level (or = 100 or100mg/24 h) and/or rate of progression in urinary AER (6% oror =6%/year), patients were divided into a high-risk group (n= 177) and a low-risk group (n= 50) for development of diabetic nephropathy. According to international guidelines, all patients at high-risk were recommended ACE-inhibitor treatment. Throughout the study, 67% of the patients were treated with an ACE inhibitor. Urinary AER significantly declined by 8.3%/year (95% CI: 2.8 to 13.9) in the whole group of patients, and the risk for the development of diabetic nephropathy during follow-up was 3.5%/year. Glycaemic control and blood pressure remained unchanged during the study. The implementation of modified international guidelines regarding the use of ACE inhibition in the treatment of microalbuminuric type 1 diabetic patients reduced progression to diabetic nephropathy comparable to what has previously been reported in intervention trials.
- Subjects :
- Blood Glucose
medicine.medical_specialty
endocrine system diseases
Clinical Biochemistry
Urology
Angiotensin-Converting Enzyme Inhibitors
Blood Pressure
Enzyme-Linked Immunosorbent Assay
urologic and male genital diseases
Nephropathy
Diabetic nephropathy
Internal medicine
medicine
Albuminuria
Humans
Diabetic Nephropathies
Type 1 diabetes
Medical Audit
biology
business.industry
Angiotensin-converting enzyme
General Medicine
medicine.disease
Endocrinology
Diabetes Mellitus, Type 1
ACE inhibitor
biology.protein
Microalbuminuria
medicine.symptom
business
medicine.drug
Kidney disease
Subjects
Details
- ISSN :
- 00365513
- Volume :
- 61
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Scandinavian journal of clinical and laboratory investigation
- Accession number :
- edsair.doi.dedup.....4ffcc4b0072f10feb5a9d599aed19c0a