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- Title
Serum total renin is increased before microalbuminuria in diabetes.
- Authors
Allen, Terri J.; Cooper, Mark E.; Gilbert, Richard E.; Winikoff, Judy; Skinner, Sandford L.; Jerums, George
- Abstract
Serum prorenin is increased in patients with insulin-dependent diabetes mellitus (IDDM) with microvascular complications. The present longitudinal study investigated whether increases in scrum total renin concentration (TRC, active+prorenin) can predict the development of microalbuminuria in IDDM patients over a 10 year period, TRC and albumin excretion rates (AER) were determined in 78 IDDM patients who were followed longitudinally for 10.4 ± 0.2 (mean ± SE) years. Twelve patients had progressively increasing albuminuria (progressors), and these were compared to 66 patients in whom albuminuria did not rise (non-progressors). The two groups had similar duration of diabetes, age, follow-up, glycemic control and blood pressure at the start of the study. Serum TRC was increased in progressors [350 (1.1) mlU/liter, geometric mean (tolerance factor)] compared to non-progressors [189 (1.2)] after 5 to 10 years duration of diabetes, and continued to rise in this group, reaching a mean of 923 mlU/liter (normal range 131 to 170) after 20 years of diabetes. When serial measurements of TRC and AER were compared in individual progressors, a significant increase in TRC was apparent up to live years before the onset of microalbuminuria. Microalbuminuria in patients with IDDM is preceded by a substantial increase in serum TRC, suggesting that serum TRC may predict the subsequent development of incipient nephropathy.
- Subjects
RENIN; DIABETES complications; DIABETES; MICROCIRCULATION disorders; KIDNEY diseases; NEPHROLOGY
- Publication
Kidney International, 1996, Vol 50, Issue 3, p902
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/ki.1996.390