Abstract |
Impaired renal function and end-stage renal disease ( ESRD) affect up to a third of patients with type 1 diabetes. Thus, strategies for early detection and for preventative interventions are of critical importance. A model of diabetic nephropathy was developed in the 1980s that placed paramount importance on the finding of microalbuminuria as an early marker of a committed process of progressive kidney disease in diabetes. However, recent studies have provided evidence that microalbuminuria is a marker of dynamic, rather than fixed, kidney injury. Preliminary studies into early renal function decline, a process measured in early nephropathy using a simple assay for cystatin C to calculate the slope of glomerular filtration rate change over time, suggest that it is a more proximal marker than microalbuminuria of a person's trajectory toward impaired renal function and ESRD. Therefore, early renal function decline, rather than microalbuminuria, may be considered as the early marker of the committed process underlying progressive diabetic nephropathy.
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Authors | Bruce A Perkins, Andrzej S Krolewski |
Journal | Current diabetes reports
(Curr Diab Rep)
Vol. 5
Issue 6
Pg. 455-63
(Dec 2005)
ISSN: 1534-4827 [Print] United States |
PMID | 16316598
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)
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Chemical References |
- Biomarkers
- CST3 protein, human
- Cystatin C
- Cystatins
- Protease Inhibitors
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Topics |
- Albuminuria
(complications, urine)
- Biomarkers
(blood, urine)
- Cystatin C
- Cystatins
(blood)
- Diabetes Mellitus, Type 1
(complications, metabolism, physiopathology)
- Diabetic Nephropathies
(etiology, metabolism, physiopathology)
- Disease Progression
- Glomerular Filtration Rate
(physiology)
- Humans
- Prognosis
- Protease Inhibitors
(blood)
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