Many patients with diabetes have significant renal dysfunction despite having normo- or microalbuminuria, according to researchers.
Jamie P. Dwyer, MD, of Vanderbilt University School of Medicine in Nashville, Tenn., and collaborators studied 11,573 diabetics in the DEMAND (Developing Education on Microalbuminuria for Awareness of Renal and Cardiovascular Risk in Diabetes) study, a global, cross-sectional study. The researchers defined normoalbuminuria as an albumin-to-creatinine ratio (ACR) below 30 mg/g, microalbuminuia as an ACR of 30-299 mg/g, and macroalbuminuria as an ACR above 300 mg/g.
The study revealed that chronic kidney disease (CKD) was present in 17% of subjects with normoalbuminuria, according to a report in CardioRenal Medicine (2012;2:1-10). Significant kidney dysfunction was found in 27% of those with microalbuminuria and 31% of participants with overt macroalbuminuria. The creatinine clearance was less than 60 mL/min in 20.5% of subjects with normoalbuminuria, 30.7% of those with microalbuminuria, and 35% of those with macroalbuminuria.