PMID- 23780946
OWN - NLM
STAT- MEDLINE
DCOM- 20140423
LR  - 20220409
IS  - 1935-5548 (Electronic)
IS  - 0149-5992 (Print)
IS  - 0149-5992 (Linking)
VI  - 36
IP  - 10
DP  - 2013 Oct
TI  - Association between remission of macroalbuminuria and preservation of renal 
      function in patients with type 2 diabetes with overt proteinuria.
PG  - 3227-33
LID - 10.2337/dc13-0281 [doi]
AB  - OBJECTIVE: Studies on the rate of remission of macroalbuminuria in patients with 
      type 2 diabetes mellitus (T2DM) and the effects of reduction in albuminuria on 
      renal prognosis in a primary care setting are absolutely lacking. RESEARCH DESIGN 
      AND METHODS: A total of 211 T2DM patients with albuminuria>/=300 mg/g were enrolled 
      in a prospective observational study (mean of 4.5 years). The incidence of 
      patients with remission of macroalbuminuria at every 1-year study time point 
      after starting intensified diabetes treatment and the factors associated with 
      remission were evaluated. The association of reduction in albuminuria with renal 
      events (doubling of serum creatinine and end-stage renal disease) was also 
      investigated. RESULTS: During the 5-year study period, remission to 
      microalbuminuria occurred in 116 patients and the 5-year cumulative incidence was 
      58.3%. Notably, most cases (82.8%) obtained remission at the 1-year study time 
      point. The remission rate increased with achieving therapeutic targets for blood 
      pressure and blood glucose. Remission and reduction in albuminuria of >/=50% were 
      associated with preservation of renal function. In particular, patients who 
      obtained both remission and 50% reduction at the 1-year study time point 
      exhibited a significantly reduced risk for renal events as compared with those 
      with no remission and no reduction (adjusted hazard ratio 0.30 [95% CI 
      0.12-0.76]). CONCLUSIONS: Remission of macroalbuminuria occurs frequently and is 
      associated with the preservation of renal function in T2DM patients. The initial 
      adequate diabetes treatment aimed at reducing albuminuria may lead to improved 
      renal prognosis in the primary care setting.
FAU - Yokoyama, Hiroki
AU  - Yokoyama H
AD  - Corresponding author: Hiroki Yokoyama, dryokoyama@yokoyamanaika.com.
FAU - Araki, Shin-ichi
AU  - Araki S
FAU - Honjo, Jun
AU  - Honjo J
FAU - Okizaki, Shinichiro
AU  - Okizaki S
FAU - Yamada, Daishiro
AU  - Yamada D
FAU - Shudo, Ryushi
AU  - Shudo R
FAU - Shimizu, Hitoshi
AU  - Shimizu H
FAU - Sone, Hirohito
AU  - Sone H
FAU - Moriya, Tatsumi
AU  - Moriya T
FAU - Haneda, Masakazu
AU  - Haneda M
LA  - eng
PT  - Journal Article
DEP - 20130618
PL  - United States
TA  - Diabetes Care
JT  - Diabetes care
JID - 7805975
SB  - IM
MH  - Aged
MH  - Albuminuria/*physiopathology
MH  - Diabetes Mellitus, Type 2/*physiopathology
MH  - Female
MH  - Humans
MH  - Kidney/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Proteinuria/*physiopathology
PMC - PMC3781501
EDAT- 2013/06/20 06:00
MHDA- 2014/04/24 06:00
PMCR- 2014/10/01
CRDT- 2013/06/20 06:00
PHST- 2013/06/20 06:00 [entrez]
PHST- 2013/06/20 06:00 [pubmed]
PHST- 2014/04/24 06:00 [medline]
PHST- 2014/10/01 00:00 [pmc-release]
AID - dc13-0281 [pii]
AID - 0281 [pii]
AID - 10.2337/dc13-0281 [doi]
PST - ppublish
SO  - Diabetes Care. 2013 Oct;36(10):3227-33. doi: 10.2337/dc13-0281. Epub 2013 Jun 18.