Clinical usefulness of measurement of urinary albumin excretion in diabetes mellitus
Stehouwer, C.D.; Donker, A.J.
Netherlands Journal of Medicine 42(5-6): 175-186
1993
ISSN/ISBN: 0300-2977 PMID: 8377876 Document Number: 414750
Mortality in diabetes mellitus is related mainly to its renal and cardiovascular sequelae. Microalbuminuria identifies those at increased risk of both complications, possibly because microalbuminuria is a marker of generalised endothelial dysfunction. Screening for microalbuminuria is of proven benefit in insulin-dependent diabetes, as therapeutic strategies are available that are at least partially effective. Such benefits have not yet been demonstrated in non-insulin-dependent diabetes. Arguments are presented to suggest that microalbuminuria should be defined on the basis of three or more daytime or 24-h urine collections. This increases sensitivity compared to the use of overnight urine collections while specificity is maintained.