Risk factors related to the development of persistent albuminuria among diabetic patients observed in a long-term follow-up.

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The incidence of persistent albuminuria among diabetic patients who had negative or trace albuminuria at the baseline of the follow-up and associated risk factors were studied. The subjects studied were 1, 196 type 2 diabetic patients who were observed until the end of 1984, for a mean follow-up period of 10 years.<BR>1) One hundred ninety-three (16.1%) patients developed persistent albuminuria with a mean period of 11.1±6.9 years after the onset of diabetes with a male preponderance. Among them, 66 (34.2%) died during the observation period, with mean period of 3.0 years after the onset of albuminuria. The prognosis of this group was extremely poor, since the mortality rate among the patients who did not develop persistent albuminuria was only 17.6%.<BR>2) The development of persistent albuminuria was associated with age, durating of diabetes, systolic blood pressure, fasting plasma glucose, presence of diabetic retinopathy and type of treatment at entry. Patients with trace albuminuria had a significantly higher incidence of persistent albuminuria than those without albuminuria at the initial visit baseline.<BR>3) The patients who developed albuminuria revealed a longer duration period, higher systolic blood pressure and plasma glucose level, higher prevalence of retinopathy and relatively higher frequency of treatment with oral hypoglycemic agents or insulin than that with diet.
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