Presse medicale (Paris, France : 1983) · 2002
[Microalbuminuria: a therapeutic goal in patients with type 2 diabetes].
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Donnelly R
Аннотация
UNLABELLED: MICROALBUMINURIA: According to the ANAES recommendations, search for microalbuminuria is a priority for monitoring patients with type 2 diabetes. The term microalbuminuria should be reserved for patients with a urinary albumin in the range of 20 to 200 micrograms/ml, i.e. 30-300 mg/24 h.
BY TYPE OF DIABETES: In type 1 diabetes, microalbuminuria is an expression of early-stage glomerulopathy which induces secondary hypertension and subsequent aggravation of the renal disease. In type 2 diabetes, microalbuminuria is also an expression of altered renal function but most importantly a marker of atheromatosis and potential coronary heart disease. Microalbuminuria may occur before the onset of diabetes; it is associated with high blood pressure which it triggers, maintains and aggravates.
PATHOGENESIS: A high level of urinary albumin appears to be related to general vascular dysfunction and particularly endothelial anomalies which allow macromolecules to leak though the endothelial barrier into the renal and retinal tissue. Microalbuminuria is undoubtedly the result of complex interactions between endocrine, metabolic, and hemodynamic factors.
IN CLINICAL PRACTICE: Microalbuminuria, which is basically a marker of vessel permeability, should lead to tighter control of blood pressure and blood glucose levels in patients with type 2 diabetes.
BY TYPE OF DIABETES: In type 1 diabetes, microalbuminuria is an expression of early-stage glomerulopathy which induces secondary hypertension and subsequent aggravation of the renal disease. In type 2 diabetes, microalbuminuria is also an expression of altered renal function but most importantly a marker of atheromatosis and potential coronary heart disease. Microalbuminuria may occur before the onset of diabetes; it is associated with high blood pressure which it triggers, maintains and aggravates.
PATHOGENESIS: A high level of urinary albumin appears to be related to general vascular dysfunction and particularly endothelial anomalies which allow macromolecules to leak though the endothelial barrier into the renal and retinal tissue. Microalbuminuria is undoubtedly the result of complex interactions between endocrine, metabolic, and hemodynamic factors.
IN CLINICAL PRACTICE: Microalbuminuria, which is basically a marker of vessel permeability, should lead to tighter control of blood pressure and blood glucose levels in patients with type 2 diabetes.