In patients with type 1 diabetes and new-onset microalbuminuria the development of advanced chronic kidney disease may not require progression to proteinuria

摘要: We sought to study new-onset microalbuminuria, its progression, and the decline of renal function in patients with type 1 diabetes. Using a cohort 109 who developed microalbuminuria first 4 years following enrollment 1st Joslin Kidney Study, we simultaneously tracked change their urinary albumin excretion. Of these, 79 were followed for an average 12 after onset, wherein glomerular filtration rate was estimated by Modification Diet Renal Disease Study formula compared proteinuria. The concordance between these outcomes weak. Only 23 progressed advanced (stage 3–5) chronic kidney disease proteinuria, which, general, did not precede but accompanied progression disease. remaining 11 had persistent or returned normal albuminuria. Thus, found that one-third diabetes relatively soon onset this conditional on presence Contrary existing concept early nephropathy diabetes, less emphasis should be placed mechanisms proteinuria more initiating promoting eventually progresses