Slide 10 of 30
Notes:
In type 1 diabetes approx. 80% of patients that develop microalbuminuria will go on to overt nephropathy over a period of 10 - 15 yrs. Without specific intervention 75% of these patients will develop ESRD within 20 years.
In contrast the prevalence of microalbuminuria is higher in type 2 diabetes but only 20 - 40% of those patients will develop overt nephropathy and only approx. 20% of these patients will go on to ESRD. Why is this?
Not all Microalbuminuria in type 2 diabetes may be caused by the same mechanism? Many of these patients may die of cardiovascular complications before they develop ESRD.
While microalbuminuria may not have the predictive value for renal disease in type 2 diabetes, it is a strong risk factor for vascular disease in patients with and without diabetes.
In 1984 Mogensen reported that microalbuminuria predicted all cause mortality in type 2 diabetes. This finding was confirmed later by Dinneen and Gerstein when they reported a strong association between microalbuminuria and cardiovascular mortality.
Why is this?
Marker for a generalized vascular hyperpermeability state
Lipid metabolism
Changes in cation membrane transport
Coagulation and endothelial dysfunction
