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Renal Hyperfiltration and the Development of Microalbuminuria in Type 1 Diabetes

OBJECTIVE: The purpose of this study was to examine prospectively whether renal hyperfiltration is associated with the development of microalbuminuria in patients with type 1 diabetes, after taking into account known risk factors. RESEARCH DESIGN AND METHODS: The study group comprised 426 participan...

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Autores principales: Ficociello, Linda H., Perkins, Bruce A., Roshan, Bijan, Weinberg, Janice M., Aschengrau, Ann, Warram, James H., Krolewski, Andrzej S.
Formato: Texto
Lenguaje:English
Publicado: American Diabetes Association 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671109/
https://www.ncbi.nlm.nih.gov/pubmed/19196883
http://dx.doi.org/10.2337/dc08-1560
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author Ficociello, Linda H.
Perkins, Bruce A.
Roshan, Bijan
Weinberg, Janice M.
Aschengrau, Ann
Warram, James H.
Krolewski, Andrzej S.
author_facet Ficociello, Linda H.
Perkins, Bruce A.
Roshan, Bijan
Weinberg, Janice M.
Aschengrau, Ann
Warram, James H.
Krolewski, Andrzej S.
author_sort Ficociello, Linda H.
collection PubMed
description OBJECTIVE: The purpose of this study was to examine prospectively whether renal hyperfiltration is associated with the development of microalbuminuria in patients with type 1 diabetes, after taking into account known risk factors. RESEARCH DESIGN AND METHODS: The study group comprised 426 participants with normoalbuminuria from the First Joslin Kidney Study, followed for 15 years. Glomerular filtration rate was estimated by serum cystatin C, and hyperfiltration was defined as exceeding the 97.5th percentile of the sex-specific distribution of a similarly aged, nondiabetic population (134 and 149 ml/min per 1.73 m(2) for men and women, respectively). The outcome was time to microalbuminuria development (multiple albumin excretion rate >30 μg/min). Hazard ratios (HRs) for microalbuminuria were calculated at 5, 10, and 15 years. RESULTS: Renal hyperfiltration was present in 24% of the study group and did not increase the risk of developing microalbuminuria. The unadjusted HR for microalbuminuria comparing those with and without hyperfiltration at baseline was 0.8 (95% CI 0.4–1.7) during the first 5 years, 1.0 (0.6–1.7) during the first 10 years, and 0.8 (0.5–1.4) during 15 years of follow-up. The model adjusted for baseline known risk factors including A1C, age at diagnosis of diabetes, diabetes duration, and cigarette smoking resulted in similar HRs. In addition, incorporating changes in hyperfiltration status during follow-up had minimal impact on the HRs for microalbuminuria. CONCLUSIONS: Renal hyperfiltration does not have an impact on the development of microalbuminuria in type 1 diabetes during 5, 10, or 15 years of follow-up.
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spelling pubmed-26711092010-05-01 Renal Hyperfiltration and the Development of Microalbuminuria in Type 1 Diabetes Ficociello, Linda H. Perkins, Bruce A. Roshan, Bijan Weinberg, Janice M. Aschengrau, Ann Warram, James H. Krolewski, Andrzej S. Diabetes Care Original Research OBJECTIVE: The purpose of this study was to examine prospectively whether renal hyperfiltration is associated with the development of microalbuminuria in patients with type 1 diabetes, after taking into account known risk factors. RESEARCH DESIGN AND METHODS: The study group comprised 426 participants with normoalbuminuria from the First Joslin Kidney Study, followed for 15 years. Glomerular filtration rate was estimated by serum cystatin C, and hyperfiltration was defined as exceeding the 97.5th percentile of the sex-specific distribution of a similarly aged, nondiabetic population (134 and 149 ml/min per 1.73 m(2) for men and women, respectively). The outcome was time to microalbuminuria development (multiple albumin excretion rate >30 μg/min). Hazard ratios (HRs) for microalbuminuria were calculated at 5, 10, and 15 years. RESULTS: Renal hyperfiltration was present in 24% of the study group and did not increase the risk of developing microalbuminuria. The unadjusted HR for microalbuminuria comparing those with and without hyperfiltration at baseline was 0.8 (95% CI 0.4–1.7) during the first 5 years, 1.0 (0.6–1.7) during the first 10 years, and 0.8 (0.5–1.4) during 15 years of follow-up. The model adjusted for baseline known risk factors including A1C, age at diagnosis of diabetes, diabetes duration, and cigarette smoking resulted in similar HRs. In addition, incorporating changes in hyperfiltration status during follow-up had minimal impact on the HRs for microalbuminuria. CONCLUSIONS: Renal hyperfiltration does not have an impact on the development of microalbuminuria in type 1 diabetes during 5, 10, or 15 years of follow-up. American Diabetes Association 2009-05 2009-02-05 /pmc/articles/PMC2671109/ /pubmed/19196883 http://dx.doi.org/10.2337/dc08-1560 Text en © 2009 by the American Diabetes Association. https://creativecommons.org/licenses/by-nc-nd/3.0/Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ (https://creativecommons.org/licenses/by-nc-nd/3.0/) for details.
spellingShingle Original Research
Ficociello, Linda H.
Perkins, Bruce A.
Roshan, Bijan
Weinberg, Janice M.
Aschengrau, Ann
Warram, James H.
Krolewski, Andrzej S.
Renal Hyperfiltration and the Development of Microalbuminuria in Type 1 Diabetes
title Renal Hyperfiltration and the Development of Microalbuminuria in Type 1 Diabetes
title_full Renal Hyperfiltration and the Development of Microalbuminuria in Type 1 Diabetes
title_fullStr Renal Hyperfiltration and the Development of Microalbuminuria in Type 1 Diabetes
title_full_unstemmed Renal Hyperfiltration and the Development of Microalbuminuria in Type 1 Diabetes
title_short Renal Hyperfiltration and the Development of Microalbuminuria in Type 1 Diabetes
title_sort renal hyperfiltration and the development of microalbuminuria in type 1 diabetes
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671109/
https://www.ncbi.nlm.nih.gov/pubmed/19196883
http://dx.doi.org/10.2337/dc08-1560
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