Albuminuria and diabetic nephropathy.

Albuminuria is characterized clinically as an early predictor for progression of diabetic nephropathy (DN). Proteinuria (macroalbuminuria) is the universal finding in progressive renal disease, and is viewed as a measure of the severity and determinant for diabetic renal disease progression. Albuminuria is a marker for early DN, an independent predictor for mortality, and is associated with renal and cardiovascular risks. The definition of albuminuria, its pathogenetic role resulting in progressive renal injury, and review of the current literature of albuminuria with its relationship to DN are discussed. Albuminuria is a predictor of albuminuria progression in DN. Tight glycemic control reduces the risk of progression from normoalbumuria to microalbuminuria, as well as from microalbuminuria to proteinuria. The relationships between albuminuria and blood pressure in renal progression and renal outcomes are examined. Clinical strategies and pharmacological agents used in reducing proteinuria in an effort to slow the progression of DN are summarized.