scholarly journals DIABETES INDUCED MICROALBUMINURIA - A CRITICAL REVIEW

2020 ◽  
Vol 08 (11) ◽  
pp. 5137-5140
Author(s):  
Binsha Salim ◽  
Madhuri Devi N
Keyword(s):  
Decisive Role ◽  
Albumin Excretion Rate ◽  
Early Morning ◽  
Albumin Creatinine Ratio ◽  
Spot Urine ◽  
Urine Albumin ◽  
Third Stage ◽  
Incipient Nephropathy ◽  
Stage Renal Disease ◽  
End Stage

Microalbuminuria is a marker and a risk factor of diabetic renal complications commences its role in path-ogenesis of nephropathy at its third stage, the stage of incipient nephropathy. Microalbuminuria is followed by overt nephropathy and end- stage renal disease of irreversible renal damage. Early detection of microal-buminuria has a decisive role in the healthy survival of diabetics. Urine albumin excretion rate and albumin creatinine ratio on timed urine samples, early morning samples or spot urine are of beneficial use. Ayurve-da describes diabetes mellitus as Prameha roga in which the major pathogenesis takes precedence in Moot-rasaya. Microalbuminuria can be described as Prameha Janya Vrikka Roga. It occurs due to Sanga (ob-struction), Vimarga Gamana (abnormal movement) of albumin; one of the constituents of Raktadhatu (blood) through Rakta and Mootra Vaha Srotas (channels of blood and urine). Medicines which are Pramehaghna (anti-diabetic), Mootra and Raktavaha Srothosodhana (cleanse the channels) may be of good worth to rectify the pathology of microalbuminuria providing an improved life for diabetics.

scholarly journals Postanalytical External Quality Assessment of Urine Albumin in Primary Health Care: An International Survey

2008 ◽  
Vol 54 (10) ◽  
pp. 1630-1636 ◽  
Author(s):  
Kristin M Aakre ◽  
Geir Thue ◽  
Sumathi Subramaniam-Haavik ◽  
Tone Bukve ◽  
Howard Morris ◽  
...  
Keyword(s):  
Diabetes Patient ◽  
Critical Difference ◽  
Albumin Creatinine Ratio ◽  
Spot Urine ◽  
Urine Albumin ◽  
Primary Health ◽  
Analytical Imprecision ◽  
Measurement Units ◽  
First Time

Abstract background: Microalbuminuria (MA) is recognized as an important risk factor for cardiovascular and renal complications in diabetes. We sought to evaluate how screening for MA is conducted and how urine albumin (UA) results are interpreted in primary care internationally. methods: General practitioners (GPs) received a case history–based questionnaire depicting a male type 2 diabetes patient in whom UA testing had not been performed. Questions were related to type of urine sample used for UA testing, need for a repeat test, whether UA testing was performed in the office laboratory, and what changes in UA results were considered clinically important [critical difference (CD)]. Participants received national benchmarking feedback reports. results: We included 2078 GPs from 9 European countries. Spot urine samples were used most commonly for first time office-based testing, whereas timed collections were used to a larger extent for hospital-based repeat tests. Repeat tests were requested by 45%–77% of GPs if the first test was positive. Four different measurement units were used by 70% of participants in estimating clinically important changes in albumin values. Stated CDs varied considerably among GPs, with similar variations in each country. A median CD of 33% was considered clinically important for both improvement and deterioration in MA, corresponding to an achievable analytical imprecision of 14%, when UA is reported as an albumin/creatinine ratio. conclusions: Guidelines on diagnosing MA are followed only partially, and should be made more practicable, addressing issues such as type of samples, measurement units, and repeat tests.

Abstract P297: Repeated Measures of Albuminuria in the Rancho Bernardo Study: 1992-2005

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Simerjot K Jassal ◽  
Jaclyn Bergstrom ◽  
Joachim Ix ◽  
Dena Rifkin ◽  
Elizabeth Barrett-Connor
Keyword(s):  
Repeated Measures ◽  
Kidney Injury ◽  
Community Dwelling ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Spot Urine ◽  
Non Invasive ◽  
Urine Albumin ◽  
Baseline Characteristics ◽  
Median Change

Albuminuria is an early, non-invasive marker of kidney injury, and an independent, potentially modifiable, risk factor for cardiovascular disease. Between 1992-96, 1764 community-dwelling men and women 31-98 (mean 71) years old were assessed for albuminuria using spot urine albumin/creatinine ratio (ACR). Median (interquartile range) ACR was 12 (7-20) mg/g. ACR was repeated in 1997-99 (n=926; ACR 12 [7-20]), 1999-2002 (n=977; ACR 16 [9-32]) and 2003-05 (n=755; ACR 11 [6-20]) (Figure). In analyses limited to 977 participants with ACR measured at 1992-96 and 1999-2002 visits, mean 6.6 (range 4.5-9.5) years later, median change in ACR was 4 (-1-17) mg/g; ACR doubled or greater in 36%, halved or less in 10%, and was unchanged in 54%. Table shows change in ACR by baseline characteristics. Using logistic regression, only sex was associated with doubling of ACR (vs. less than doubling); OR 1.42 (95% CI 1.08-1.87, p=0.01) for women; age, blood pressure, and diabetes were not; none of these were associated with halving of ACR. Further studies of predictors of albuminuria may inform future interventions to modify albuminuria and mitigate kidney and cardiovascular risk.

scholarly journals Persistent Microalbuminuria in Human Immunodeficiency Virus Infected Children in Kano, Nigeria

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Abdullahi Mudi ◽  
Bashir U. Alhaj ◽  
Fatimah Hassan-Hanga ◽  
Isah Adagiri Yahaya
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Early Morning ◽  
Urine Samples ◽  
Female Ratio ◽  
Albumin Creatinine Ratio ◽  
Spot Urine ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Duration Of Infection ◽  
Male To Female

Microalbuminuria has been reported to be a precursor of HIV related renal disease, which if detected early and coupled with appropriate intervention may slow or retard the progress of the disease. One hundred and seventy-eight HIV infected children aged 15 years and below were recruited from the Paediatric Infectious Disease Clinic of Aminu Kano Teaching Hospital (AKTH), Kano, to determine the prevalence of persistent microalbuminuria using the albumin creatinine ratio (ACR). Early morning urine samples and spot urine samples were analyzed using a dipstick specific for microalbumin. Those who tested positive had their samples reanalyzed in the laboratory using immunometric assay and Jaffe reaction method for albumin and creatinine, respectively. Patients that had ACR of 30–300 mg/g were said to have microalbuminuria and had their urine samples retested after 6 to 8 weeks. Twelve children (6.7%) had persistent microalbuminuria and had a mean age of7.5±3.3years, with a male to female ratio of 1 : 1. There was no significant relationship between the finding of microalbuminuria and age, sex, duration of infection, and the use of highly active antiretroviral therapy. Periodic screening for microalbuminuria using albumin specific dipstick should be considered for children with HIV infection.

scholarly journals Optimal Early Diagnosis and Monitoring of Diabetic Kidney Disease in Type 2 Diabetes Mellitus: Addressing the Barriers to Albuminuria Testing

2021 ◽  
Vol 12 ◽  
pp. 215013272110036
Author(s):  
Elena A. Christofides ◽  
Niraj Desai
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Urine Albumin ◽  
Increased Risk ◽  
Ckd Stage ◽  
Stage Renal Disease ◽  
End Stage ◽  
Kidney Health

Chronic kidney disease (CKD) in patients with type 2 diabetes (T2D) is associated with increased risk of end-stage renal disease (ESRD) and cardiovascular disease (CVD). Urine albumin-to-creatinine ratio (UACR) is a sensitive and early indicator of kidney damage, which should be used routinely to accurately assess CKD stage and monitor kidney health. However, this test currently is performed in only a minority of patients with T2D. Here, we review the importance of albuminuria testing and current barriers that hinder patient access to UACR testing and describe solutions to such testing in a community clinical setting.

Secondary Hyperparathyroidism in the Diabetic Patient with Chronic Kidney Disease

2005 ◽  
Vol 00 (01) ◽  
pp. 39
Author(s):  
Steven Cheng ◽  
Daniel Coyne
Keyword(s):  
Chronic Kidney Disease ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Renal Involvement ◽  
Urine Albumin Excretion ◽  
Albumin Excretion ◽  
Urine Albumin ◽  
Overt Proteinuria ◽  
Stage Renal Disease ◽  
End Stage

In the US, diabetic nephropathy accounts for the majority of chronic kidney disease (CKD). It contributes significantly to morbidity and mortality among the diabetic population1,2and accounts for approximately 40% of patients with end-stage renal disease.3The earliest manifestation of renal involvement in diabetes is the presence of microalbuminuria, as defined by urine albumin excretion of 30–300mg/day.4Progression to overt proteinuria (urine albumin excretion greater than 300mg/day) and diabetic nephropathy occur more frequently in those with poor glycemic control, glomerular hyperfiltration, and hypertension.5

P0990RENINAAV DOSE-DEPENDENTLY EXACERBATE ALBUMINURIA AND GLOMERULOSCLEROSIS, AND REDUCE GFR IN FEMALE UNINEPHRECTOMIZED DB/DB MICE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mette Viberg Østergaard ◽  
Rune Ida ◽  
Annemarie Aarup Pedersen ◽  
Thomas Secher ◽  
Frederikke Emilie Sembach ◽  
...  
Keyword(s):  
Gene Expression ◽  
Kidney Injury ◽  
Negative Control ◽  
Tubular Injury ◽  
Spot Urine ◽  
Recent Emergence ◽  
Induced Hypertension ◽  
Stage Renal Disease ◽  
End Stage ◽  
Diabetes Patients

Abstract Background and Aims Diabetic nephropathy (DN) is a long-term complication that occurs in ∼40% of diabetes patients and is a leading cause of end-stage renal disease. Despite recent emergence of SGLT2 inhibitors and GLP-1 receptor agonists for nephroprotection in diabetes patients, drug discovery has been halted by the lack of reliable rodent models exhibiting features of human DN. In a newly established mouse model of progressive DN, we investigate the effects of hypertension on kidney injury. Method Female db/db mice were uninephrectomized (UNx) at 8 weeks of age and injected i.v. with a Renin adeno-associated virus (AAV) construct at different doses to induce hypertension, while a LacZAAV construct was used as negative control. db/+ mice served as healthy controls. Hypertension was measured by tail cuff and glomerular filtration rate (GFR) transcutaneous recoding of FITC-sinistrin after i.v. bolus injection at 22 weeks of age. Urine ACR measured in spot urine samples collected before termination 24 weeks of age. Terminal kidney samples were collected for 3D image analyses, histopathological evaluation, and next generation sequencing for gene expression analyses. Results GFR measurements indicated hyperfiltration in all AAV-injected UNx db/db mice compared to db/+ mice, while ReninAAV tended to dose-dependently decrease GFR compared to LacZAAV in UNx db/db mice. Urine ACR was worsened by ReninAAV-induced hypertension compared to LacZAAV controls. Automized AI-based glomerulosclerosis scoring showed ReninAAV dose-dependent increases in glomerulosclerosis compared to LacZAAV controls. 3D kidney imaging demonstrated increased glomerular volume in LacZAAV UNx db/db mice compared to db/+ mice with no further effect in ReninAAV groups. RNA sequencing revealed upregulated gene expression markers of fibrogenesis (incl. Col1a1, Col3, Col4, Fn1, Lamc2 and Vim) and tubular injury markers (Ngal and Kim-1), as well as downregulation of proximal tubular markers (Megalin and Aqp1) in ReninAAV UNx db/db mice compare to LacZAAV controls. Conclusion ReninAAV-induced hypertension in female UNx db/db mice accelerates kidney injury in uninephrectomized db/db mice and aggravates GFR, albuminuria and glomerulosclerosis in parallel with increased expression of genes associated with tubular injury renal fibrosis. Together, these data confirm that ReninAAV UNx db/db mice is a reliable model of DN with features of late stage human disease.

scholarly journals Urine 5MedC, a Marker of DNA Methylation, in the Progression of Chronic Kidney Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Akifumi Onishi ◽  
Hitoshi Sugiyama ◽  
Masashi Kitagawa ◽  
Toshio Yamanari ◽  
Keiko Tanaka ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Dna Methylation ◽  
Kidney Disease ◽  
Renal Outcome ◽  
Enzyme Linked Immunosorbent Assay ◽  
Spot Urine ◽  
Logistic Regression Models ◽  
Urine Albumin ◽  
Stage Renal Disease ◽  
Urine Levels

Background. Alterations in DNA methylation may be involved in disease progression in patients with chronic kidney disease (CKD). Recent studies have suggested that 5-methyl-2′-deoxycytidine (5MedC) may be a marker of hypermethylation of DNA. Currently, there is no information available regarding the urine levels of 5MedC and its association with the progression of CKD. Method. We examined the urine levels of 5MedC in spot urine samples from 308 patients with CKD (median age: 56 years, male: 53.2%, and glomerulonephritis: 51.0%) using a competitive enzyme-linked immunosorbent assay and investigated the relationships among urine 5MedC, urine albumin, urine α1-microglobulin (α1MG), and the laboratory parameters associated with CKD. The patients were followed for three years to evaluate renal endpoints in a prospective manner. Results. The urine 5MedC level was significantly increased in the later stages of CKD compared to the early to middle stages of CKD. In multiple logistic regression models, urine 5MedC was significantly associated with the prediction of later CKD stages. Urine 5MedC (median value, 65.9 μmol/gCr) was significantly able to predict a 30% decline in the estimated GFR or a development of end-stage renal disease when combined with macroalbuminuria or an increased level of urine α1MG (median value, 5.7 mg/gCr). Conclusion. The present data demonstrate that the urine 5MedC level is associated with a reduced renal function and can serve as a novel and potent biomarker for predicting the renal outcome in CKD patients. Further studies will be necessary to elucidate the role of urine DNA methylation in the progression of CKD.

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