Diabetic Medicine 1995; 12:261-266

Beatty OL, Ritchie CM, Bell PM et al

Microalbuminaria as identified by a spot morning urine specimen in
NIDD; an 8 year follow up study.

There is no consensus on the best method of testing for
microalbuminuria.

The study followed a cohort of 47 NIDDM patients with microalbuminuria
detected on spot morning urine sample.

Subjects were compared with randomly selected, age -matched controls
who did not have microalbuminuria when study started in 1984.

8 years later, a substantial excess mortality, mainly from
cardiovascular causes, was found in the patients with microalbuminuria
at the start of the study.

Although these patients had a significantly higher systolic blood
pressure and glycosylated haemoglobin, microalbuminuria remained an
independent predictor of all cause mortality after adjustment for these
factors.

At the conclusion of the study in 1992, 22 of the 47 patients with
microalbuminuria had died compared with 10 of the 47 patients without.

In the group without micro albuminuria in 1984, only one patient had
microalbuminuria when retested in 1992. No patients had nephropathy.

Of the patients with micro-albubiminuria who were alive at the end of
the study, 5 had nephropathy.

No patients died from chronic renal failure.

Six patients with microalbuminuria at the start of the study did not
have it at the end.

The mean age of the patients was 64 years in 1984

Patients with microalbuminuria had had diabetes for a mean of 7.2 years
and those without for a mean of 9.1 years.

-Bruce Beale, London, UK