proteinuria
Too much protein in the urine. This may be a sign of kidney damage.

Note: Eating protein does not cause proteinuria.

Diabetes Week
Publisher: CW Henderson
Issue: August 5, 2002
Page: 3

Prognosis
Proteinuria increases mortality risk for type 2 diabetic patients

2002 AUG 5 - (NewsRx.com) -- by Maria G. Essig, MS, ELS, senior medical writer - Proteinuria was a strong predictor of mortality, independent of other risk factors, in patients with type 2 diabetes, according to researchrs in the U.K.

"The causes and mechanisms of increased mortality of patients with diabetic nephropathy are unclear, and its natural history is poorly understood," commented E.B. Jude and colleagues at Manchester University.

The investigators used data from a secondary care register to perform a retrospective study of 170 type 2 diabetes patients who exhibited nephropathy, defined as proteinuria greater than 0.5 g/24 h, and 170 control subjects without nephropathy. Follow-up time was from 2-10 years (average of 5.3 years) or until death.

Patients with nephropathy at baseline were significantly more likely to die within the follow-up period than were the control subjects (37% vs. 8%, respectively; p<0.0001). After adjusting for age and sex, the mortality from all causes was 8.1 deaths/100 person-years for test subjects compared with 1.4 deaths/100 person-years for control subjects (rate ratio 5.8).

A proportional correlation existed between mortality and the amount of proteinuria, with 4.6 deaths/100 people-years for proteinuria 0.5-2 g/24 h, to 9.9 deaths/100 people-years for proteinuria greater than 2 g/24 h. Each log increase in proteinuria amount was associated with a 36% greater risk of death; patients with nephropathy were 5 times more likely to die from cardiovascular complications and all other causes than were control subjects.

Other risk factors for mortality included baseline age, creatinine levels, and degree of glycemic control (Natural history and prognostic factors of diabetic nephropathy in type 2 diabetes. QJM - Monthly Journal of the Association of Physicians, 2002;95(6):371-377).

"Proteinuria is a potentially preventable and reversible risk factor associated with high mortality in type 2 diabetic patients," concluded Jude and coauthors. "Prevention of the development of overt nephropathy and improvement in diabetes control may reduce mortality in these patients,"

The corresponding author for this study is E.B. Jude, Tameside General Hospital, Diabetes Centre, Fountain Road, Ashton-under-Lyne, Lancashire OL6 9RW, UK. E-mail: ejude~man.ac.uk.

Key points reported in this study include:

• Type 2 diabetic patients with proteinuria had a significantly higher mortality rate than those without proteinuria.

• The mortality rate of type 2 diabetic patients was directly proportional to the amount of proteinuria - as proteinuria increased, so did mortality rate.

• Other risk factors that increased mortality rate included higher baseline age, increased creatinine, and poor glycemic control.

This article was prepared by Diabetes Week editors from staff and other reports. Copyright 2002, Diabetes Week via NewsRx.com.