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How to predict nephropathy in type 1 diabetic patients - Routine data or provocation by exercise testing?

Dash, R and Torffvit, Ole LU (2003) In Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00 37(5). p.437-442
Abstract
Objective: Do exaggerated increases in blood pressure and albuminuria during exercise occur earlier than microalbuminuria and which type of test is most predictive of diabetic nephropathy? Material and Methods: A total of 33 insulin-dependent normoalbuminuric men (mean duration of diabetes 14 years; mean age 28 years) and 34 age-matched apparently healthy control subjects were studied. Urinary albumin excretion, heart rate and blood pressure were measured during fixed workload (150 W) and fixed heart rate (155 beats/min) tests. Mean follow-up time was 13.1 +/- 3.2 years. A urinary albumin level in early-morning urine persistently >30 mg/l was considered a sign of diabetic nephropathy. Results: Sixteen patients reached the endpoints of... (More)
Objective: Do exaggerated increases in blood pressure and albuminuria during exercise occur earlier than microalbuminuria and which type of test is most predictive of diabetic nephropathy? Material and Methods: A total of 33 insulin-dependent normoalbuminuric men (mean duration of diabetes 14 years; mean age 28 years) and 34 age-matched apparently healthy control subjects were studied. Urinary albumin excretion, heart rate and blood pressure were measured during fixed workload (150 W) and fixed heart rate (155 beats/min) tests. Mean follow-up time was 13.1 +/- 3.2 years. A urinary albumin level in early-morning urine persistently >30 mg/l was considered a sign of diabetic nephropathy. Results: Sixteen patients reached the endpoints of the study. Eleven had developed microalbuminuria and five macroalbuminuria (persistent levels of urinary albumin >300 mg/l). Of the latter patients, two needed dialysis. Systolic blood pressure and albumin excretion during the fixed heart rate test were higher in diabetic patients who developed signs of nephropathy than in control subjects and diabetic subjects with persistent healthy kidneys. Such differences were not found in the fixed workload test. There were no differences in glycated haemoglobin, blood pressure levels or albumin excretion at baseline between the two diabetic groups. Conclusions: To predict the development of diabetic nephropathy it seems important to choose a fixed heart rate test. High levels of systolic blood pressure in such a test were associated with the development of micro- and macroalbuminuria. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
diabetic nephropathy, albuminuria, blood pressure, prognosis, exercise test
in
Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00
volume
37
issue
5
pages
437 - 442
publisher
Taylor & Francis
external identifiers
  • wos:000186295000014
  • pmid:14594696
  • scopus:0344010595
ISSN
0036-5599
DOI
10.1080/00365590310021159
language
English
LU publication?
yes
id
35c77c4b-6b4c-43de-9ebf-5a4228c230cf (old id 296392)
date added to LUP
2007-08-29 10:27:48
date last changed
2018-01-07 08:41:57
@article{35c77c4b-6b4c-43de-9ebf-5a4228c230cf,
  abstract     = {Objective: Do exaggerated increases in blood pressure and albuminuria during exercise occur earlier than microalbuminuria and which type of test is most predictive of diabetic nephropathy? Material and Methods: A total of 33 insulin-dependent normoalbuminuric men (mean duration of diabetes 14 years; mean age 28 years) and 34 age-matched apparently healthy control subjects were studied. Urinary albumin excretion, heart rate and blood pressure were measured during fixed workload (150 W) and fixed heart rate (155 beats/min) tests. Mean follow-up time was 13.1 +/- 3.2 years. A urinary albumin level in early-morning urine persistently >30 mg/l was considered a sign of diabetic nephropathy. Results: Sixteen patients reached the endpoints of the study. Eleven had developed microalbuminuria and five macroalbuminuria (persistent levels of urinary albumin >300 mg/l). Of the latter patients, two needed dialysis. Systolic blood pressure and albumin excretion during the fixed heart rate test were higher in diabetic patients who developed signs of nephropathy than in control subjects and diabetic subjects with persistent healthy kidneys. Such differences were not found in the fixed workload test. There were no differences in glycated haemoglobin, blood pressure levels or albumin excretion at baseline between the two diabetic groups. Conclusions: To predict the development of diabetic nephropathy it seems important to choose a fixed heart rate test. High levels of systolic blood pressure in such a test were associated with the development of micro- and macroalbuminuria.},
  author       = {Dash, R and Torffvit, Ole},
  issn         = {0036-5599},
  keyword      = {diabetic nephropathy,albuminuria,blood pressure,prognosis,exercise test},
  language     = {eng},
  number       = {5},
  pages        = {437--442},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00},
  title        = {How to predict nephropathy in type 1 diabetic patients - Routine data or provocation by exercise testing?},
  url          = {http://dx.doi.org/10.1080/00365590310021159},
  volume       = {37},
  year         = {2003},
}