Urinary protein excretion—even in the normal range—raises diabetics' heart risks

August 30, 2012

In individuals with type 2 diabetes, any degree of measurable urinary protein excretion—even in what is considered the normal range—increases their risk of experiencing heart problems, according to a study appearing in an upcoming issue of new study in the Journal of the American Society of Nephrology (JASN). The findings could help identify patients who should be treated with cardioprotective medications.

Some patients with type 2 diabetes experience kidney problems that cause them to excrete increased amounts of the protein albumin in their urine, a condition called albuminuria. These patients have a considerably higher risk of developing —such as heart attacks, strokes, and —than other diabetic patients and people in the general population, who are "normoalbuminuric," with urinary albumin excretion levels of less than 20 μg/min.

Investigators have wondered if any level of albumin excretion—for example at a level that is the upper range of what is considered normal—might increase a diabetic patient's risk of developing heart problems. "It would be important to know whether there is a level for albuminuria that differentiates individuals in need of cardioprotective intervention from those with a low risk," said Giuseppe Remuzzi, MD, FRCP, (Mario Negri Institute for Pharmacological Research and Ospedali Riuniti, in Bergamo, Italy). "This is a major health issue since patients with normoalbuminuria account for at least 90% of the diabetic population," he added.

Through an extension of a clinical trial originally designed for other purposes, Dr. Remuzzi, along with Piero Ruggenenti, MD, Esteban Porrini MD (Mario Negri Institute for ), and others, evaluated the relationship between albumin excretion levels and heart problems in 1,208 normoalbuminuric patients with who were followed for an average of 9.2 years.

The researchers found that any degree of measurable albumin excretion bore significant heart risks:

  • For each 1 μg/min in albumin excretion at the start of the study, there was a progressive incremental risk of experiencing heart problems during follow-up.
  • Even albuminuria of 1-2 μg/min significantly associated with increased risk compared with albuminuria <1 μg/min.
When the investigators looked only at the subgroup of patients who took antihypertensive drugs called ACE inhibitors from the start of the study and throughout the follow-up period, they found no link between albumin excretion levels and heart risks. This suggests that ACE inhibitors have heart-protective properties that may benefit diabetic patients with albuminuria and normoalbuminuria alike. Future clinical trials are needed to identify levels of excretion above which such cardioprotective therapy is beneficial.

More information: The article, entitled "Measurable Urinary Albumin Predicts Cardiovascular Risk Among Normoalbuminuric Type 2 Diabetics," will appear online on August 30, 2012, doi: 10.1681/ASN.2012030252

Related Stories

Recommended for you

New approach to tracking how deadly 'superbugs' travel could slow their spread

November 22, 2017
Killer bacteria - ones that have out-evolved our best antibiotics—may not go away anytime soon. But a new approach to tracking their spread could eventually give us a fighting chance to keep their death toll down.

Research points to diagnostic test for top cause of liver transplant in kids

November 22, 2017
Biliary atresia is the most common cause of liver transplants for children in the United States. Now researchers report in Science Translational Medicine finding a strong biomarker candidate that could be used for earlier ...

Rainfall can indicate that mosquito-borne epidemics will occur weeks later

November 22, 2017
A new study demonstrates that outbreaks of mosquito-borne viruses Zika and Chikungunya generally occur about three weeks after heavy rainfall.Researchers also found that Chikungunya will predominate over Zika when both circulate ...

Metabolites altered in chronic kidney disease

November 22, 2017
Chronic kidney disease (CKD) affects 1 in 7 people in the United States, according to the U.S. National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK). These individuals have a very high risk of cardiovascular ...

Alcohol consumption and metabolic factors act together to increase the risk of severe liver disease

November 22, 2017
A new study provides insights into the interaction between alcohol consumption and metabolic factors in predicting severe liver disease in the general population. The findings, which are published in Hepatology, indicate ...

Gastric acid suppressant lansoprazole may target tuberculosis

November 21, 2017
A cheap and widely used drug, used to treat conditions such as heartburn, gastritis and ulcers, could work against the bacteria that cause tuberculosis (TB), according to new research from UCL and the London School of Hygiene ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.