Abstract
We studied urinary albumin, renal function decline, and arteriosclerosis in 505 outpatients with diabetes-54% men, mean age: 65 years. The albumin creatinine ratio (ACR) of spot-urine samples showed normoalbumiuria in 58%, microalbuminuria in 31%, and macroalbuminuria in 11%. Normoalbuminuria and microalbuminuria subjects were respectively classified into lower and higher groups by their median levels of urinary ACR. Annual change in estimated glomerular filtration rate (eGFR) and level of pulse wave velocity (PWV) were compared among the five groups, i.e., lower and higher normoarubuminuria, lower and higher microalbuminuria, and macroalbuminuria. Average eGFR changes (ml/min/1.73 m2/year) were -1.8, -3.3, -3.3, -3.9, and -4.3. Average levels of PWV (cm/s) were 1642, 1810, 1869, 1957, and 2018. Compared to the subjects with lower normoalbuminuria, those with higher had faster eGFR decline and more increased PWV, together with increased levels of diabetes duration, HbA1c, BMI, and blood pressure which are associated with both renal function and arteriosclerosis. Our results indicate that faster decline in renal function and increased arteriosclerosis are found from normoalbuminuria in those with diabetes.
