Microalbuminuria linked to CV mortality in type 2
Från Arch Intern Med 2000;160:1093-1100

In patients with adult-onset diabetes mellitus, both microalbuminuria and gross proteinuria are significantly associated with mortality from cardiovascular disease.

    In a report in the April 24th issue of the Archives of Internal Medicine, Dr. Ronald Klein and colleagues from the University of Wisconsin-Madison Medical School, in Madison, describe a prospective study of 840 patients with older-onset diabetes mellitus who were part of the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Of these patients, 54.8% had normal urinary albumin levels, 24.8% had microalbuminuria and 20.5% had gross proteinuria.

Follow-up
    After a 12-year follow-up period and controlling for various factors, Dr. Klein's group found that the relative risk of cardiovascular mortality was significantly higher in patients with microalbuminuria or gross proteinuria compared with patients with normoalbuminuria. Patients with microalbuminuria had a relative risk of 1.84, while patients with gross proteinuria had a relative risk of 2.61. In addition, they found increased relative risks for the combined endpoint of mortality from coronary heart disease, stroke or all causes for patients with either microalbuminuria or gross proteinuria.

Conclusions

    "Older-onset diabetic persons with

albuminuria may significantly profit from aggressive efforts to correct contributing risk factors such as hyperglycemia, hypertension, dyslipoproteinemia, smoking, obesity, and physical inactivity," Dr. Klein's group writes. They add that "further data from population-based incidence studies and clinical trials, as well as from populations with a sizeable proportion of patients newly diagnosed as having diabetes, are needed to determine whether albuminuria is indeed an independent risk factor for the development of incident cardiovascular disease."

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