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The incidence of nephropathy in type 1 diabetic patients with proliferative retinopathy: a 10-year follow-up study

Lövestam Adrian, Monica LU ; Agardh, Elisabet LU and Agardh, Carl-David LU (1998) In Diabetes Research and Clinical Practice 39(1). p.11-17
Abstract
Patients with type 1 diabetes mellitus and with proliferative retinopathy often have a concomitant diabetic nephropathy. However, in cross-sectional studies it has been shown that 35% of patients with proliferative retinopathy do not show signs of diabetic nephropathy. The aim of the present study was to examine the incidence of diabetic nephropathy in type 1 diabetic patients with proliferative retinopathy but without signs of nephropathy. To that end, out of 102 consecutive patients with proliferative retinopathy attending the University Hospital, Lund, in 1986, 24 patients did not show any clinical signs of nephropathy, and were followed for 10 years regarding the development of nephropathy. Their age was 36.7 +/- 9.8 years, age at... (More)
Patients with type 1 diabetes mellitus and with proliferative retinopathy often have a concomitant diabetic nephropathy. However, in cross-sectional studies it has been shown that 35% of patients with proliferative retinopathy do not show signs of diabetic nephropathy. The aim of the present study was to examine the incidence of diabetic nephropathy in type 1 diabetic patients with proliferative retinopathy but without signs of nephropathy. To that end, out of 102 consecutive patients with proliferative retinopathy attending the University Hospital, Lund, in 1986, 24 patients did not show any clinical signs of nephropathy, and were followed for 10 years regarding the development of nephropathy. Their age was 36.7 +/- 9.8 years, age at onset 11.8 +/- 7.5 years, diabetes duration 25.7 +/- 6.9 years and duration of proliferative retinopathy 4.6 +/- 3.8 years (mean +/- S.D.). At entry, no patient had albuminuria (< 30 mg/l), and albumin creatinine clearance ratio was < 0.01 x 10(-3). During the 10-year follow-up period, two of the patients showed isolated higher peaks of elevated urinary albumin, but none of the 24 patients developed persistent microalbuminuria (> or = 30 mg/l). Two patients died before follow-up, but none of these had developed microalbuminuria at the time for death. Based on mean annual measurements, there were no increases in HbA1c, systolic and diastolic blood pressure, and serum creatinine levels. At entry, seven of the patients were treated with antihypertensive drugs and another three patients received such treatment during the study period. In conclusion, in a subgroup of patients with proliferative retinopathy, i.e. without clinical signs of diabetic nephropathy, no patient developed persistent microalbuminuria during a 10-year follow-up period. These results indicate further evidence for at least partly different pathogenic mechanisms behind diabetic retinopathy and nephropathy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Proliferative retinopathy, Nephropathy, Type 1 diabetes
in
Diabetes Research and Clinical Practice
volume
39
issue
1
pages
11 - 17
publisher
Elsevier
external identifiers
  • pmid:9597369
  • scopus:0344074528
ISSN
1872-8227
DOI
10.1016/S0168-8227(97)00106-X
language
English
LU publication?
yes
id
ff70ec65-fbf9-4b21-b020-1a889717c0d0 (old id 1112652)
date added to LUP
2008-07-10 11:05:24
date last changed
2017-06-11 03:29:11
@article{ff70ec65-fbf9-4b21-b020-1a889717c0d0,
  abstract     = {Patients with type 1 diabetes mellitus and with proliferative retinopathy often have a concomitant diabetic nephropathy. However, in cross-sectional studies it has been shown that 35% of patients with proliferative retinopathy do not show signs of diabetic nephropathy. The aim of the present study was to examine the incidence of diabetic nephropathy in type 1 diabetic patients with proliferative retinopathy but without signs of nephropathy. To that end, out of 102 consecutive patients with proliferative retinopathy attending the University Hospital, Lund, in 1986, 24 patients did not show any clinical signs of nephropathy, and were followed for 10 years regarding the development of nephropathy. Their age was 36.7 +/- 9.8 years, age at onset 11.8 +/- 7.5 years, diabetes duration 25.7 +/- 6.9 years and duration of proliferative retinopathy 4.6 +/- 3.8 years (mean +/- S.D.). At entry, no patient had albuminuria (&lt; 30 mg/l), and albumin creatinine clearance ratio was &lt; 0.01 x 10(-3). During the 10-year follow-up period, two of the patients showed isolated higher peaks of elevated urinary albumin, but none of the 24 patients developed persistent microalbuminuria (&gt; or = 30 mg/l). Two patients died before follow-up, but none of these had developed microalbuminuria at the time for death. Based on mean annual measurements, there were no increases in HbA1c, systolic and diastolic blood pressure, and serum creatinine levels. At entry, seven of the patients were treated with antihypertensive drugs and another three patients received such treatment during the study period. In conclusion, in a subgroup of patients with proliferative retinopathy, i.e. without clinical signs of diabetic nephropathy, no patient developed persistent microalbuminuria during a 10-year follow-up period. These results indicate further evidence for at least partly different pathogenic mechanisms behind diabetic retinopathy and nephropathy.},
  author       = {Lövestam Adrian, Monica and Agardh, Elisabet and Agardh, Carl-David},
  issn         = {1872-8227},
  keyword      = {Proliferative retinopathy,Nephropathy,Type 1 diabetes},
  language     = {eng},
  number       = {1},
  pages        = {11--17},
  publisher    = {Elsevier},
  series       = {Diabetes Research and Clinical Practice},
  title        = {The incidence of nephropathy in type 1 diabetic patients with proliferative retinopathy: a 10-year follow-up study},
  url          = {http://dx.doi.org/10.1016/S0168-8227(97)00106-X},
  volume       = {39},
  year         = {1998},
}