The prevalence of microalbuminuria and associated risk factors in a population with insulin-dependent diabetes mellitus.

The prevalence of microalbuminuria was studied in a clinic population of patients with insulin-dependent diabetes mellitus [IDDM] with disease duration longer than 5 years. 75 patients were included in the study, 23 patients (30.7%) had microalbuminuria and 2 patients (2.7%) had macroalbuminuria. Comparison of the clinical and laboratory characteristics of patients with microalbuminuria (n = 23) to patients with normoalbuminuria (n = 50) showed no differences with respect to age, duration of diabetes, blood pressure, presence of retinopathy and glycosylated haemoglobin. The mean glomerular filtration rate (GFR) was higher in the microalbuminuric group than in the normoalbuminuric group (125 +/- 45 ml/min compared to 99 +/- 32 ml/min; P < 0.05). In a multiple regression model excluding patients with macroalbuminuria the following predictors of albumin excretion rate (AER) were identified: systolic blood pressure, glycosylated haemoglobin and GFR. Since microalbuminuria is common in Irish patients with IDDM, we suggest that AER should be determined as part of the annual routine screen. Stricter control of blood pressure and glycaemia should be considered.