Incidence of proteinuria in type 2 diabetes mellitus in the Pima Indians

Incidence of proteinuria in type 2 diabetes mellitus in the Pima Indians

Incidence of proteinuria in type 2 diabetes mellitus in the Pima Indians. Little is known of the natural history of nephropathy in type 2 (non-insulin-dependent) diabetes, yet type 2 diabetes is a major cause of end-stage renal disease in the United States. The incidence rate of heavy proteinuria wa...

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Bibliographic Details
Published in:Kidney international Vol. 35; no. 2; pp. 681 - 687
Main Authors: Kunzelman, Charles L., Knowler, William C., Pettitt, David J., Bennett, Peter H.
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01-02-1989
Nature Publishing
Subjects:
Adult
Arizona
Associated diseases and complications
Biological and medical sciences
Child
Cohort Studies
Diabetes Mellitus, Type 2 - urine
Diabetes. Impaired glucose tolerance
Diabetic Nephropathies - epidemiology
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Female
Humans
Indians, North American
Longitudinal Studies
Male
Medical sciences
Middle Aged
Proteinuria - epidemiology
Risk Factors
Arizona
Endocrinopathy
Human
Urinary system disease
Complication
Non insulin dependent diabetes
Ethnic group
Incidence
Proteinuria
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Summary:Incidence of proteinuria in type 2 diabetes mellitus in the Pima Indians. Little is known of the natural history of nephropathy in type 2 (non-insulin-dependent) diabetes, yet type 2 diabetes is a major cause of end-stage renal disease in the United States. The incidence rate of heavy proteinuria was determined in Pima Indians participating in a longitudinal population study of diabetes and its complications. Heavy proteinuria was defined by a urine protein (g/liter) to urine creatinine (g/liter) ratio ≥ 1.0 (≥ 113mg protein/mmol creatinine), a level which corresponds to a urine protein excretion rate of about 1 g/day. The incidence rates of proteinuria in diabetic Pimas were 4, 12, 37, and 106 cases/1,000 person-years at risk in the periods 0 to 5, 5 to 10, 10 to 15, and 15 to 20 years after the diagnosis of diabetes. The cumulative incidence rates were 2%, 8%, 23%, and 50% at 5, 10, 15, and 20 years, respectively. The duration of diabetes, severity of diabetes as determined by the degree of hyperglycemia and type of treatment, and blood pressure were risk factors for proteinuria. The presence of heavy proteinuria was strongly associated with the development of renal insufficiency, defined by serum creatinine ≥ 2.0 mg/dl (≥ 177 µmol/liter). The incidence of proteinuria in type 2 diabetes in Pima Indians was as high as that reported in type 1 diabetes in other populations and represents a frequent, serious complication of the disease.
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ISSN:0085-2538
1523-1755
DOI:10.1038/ki.1989.39