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Diabetes 54:2983-2987, 2005
© 2005 by the American Diabetes Association, Inc.

Factors Associated With Frequent Remission of Microalbuminuria in Patients With Type 2 Diabetes

Shin-ichi Araki1, Masakazu Haneda2, Toshiro Sugimoto1, Motohide Isono1, Keiji Isshiki1, Atsunori Kashiwagi1, and Daisuke Koya1,3

1 Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
2 Second Department of Medicine, Asahikawa Medical College, Asahikawa, Hokkaido, Japan
3 Department of Medicine, Division of Endocrinology & Metabolism, Kanazawa Medical School, Ishikawa, Japan

To estimate the frequency of remission/regression of microalbuminuria and to identify factors affecting such outcomes in Japanese patients with type 2 diabetes, we observed 216 patients with type 2 diabetes and microalbuminuria enrolled during an initial 2-year evaluation period for the next 6 years. Remission was defined as shift to normoalbuminuria and regression as a 50% reduction in urinary albumin excretion rate (AER) from one 2-year period to the next. Reduction of urinary AER was frequent, with a 6-year cumulative incidence of 51% (95% CI 42–60) for remission and 54% (45–63) for regression, whereas the frequency of progression to overt proteinuria was 28% (19–37). Microalbuminuria of short duration, the use of renin-angiotensin system-blocking drugs, and lower tertiles for HbA1c (<6.95%) and systolic blood pressure (<129 mmHg) were independently associated with remission or regression in the pooled logistic regression analysis. The results indicate that reduction in urinary AER occurs frequently in Japanese patients with type 2 diabetes. Early detection of microalbuminuria and a multifactorial control may result in improved outcomes for diabetic nephropathy and cardiovascular events.

Address correspondence and reprint requests to Shin-ichi Araki, MD, PhD, Department of Medicine, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan. E-mail: araki{at}belle.shiga-med.ac.jp

Abbreviations: AER, albumin excretion rate; ARB, angiotensin II type 1 receptor blocker; ESRD, end-stage renal disease; RAS, renin-angiotensin system; SBP, systolic blood pressure


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Copyright © 2005 by the American Diabetes Association.