Lege Artis Medicinae

[The prevalence of microalbuminuria in patients with insulin-dependent diabetes mellitus and hypertension]

BIBOK György1, TAMÁS Gyula1, KERÉNYI Zsuzsa2, BALÁZS Ottó2, TÓTH Jenő3

APRIL 28, 1993

Lege Artis Medicinae - 1993;3(04)

[The aim of this study was to evaluate the prevalence of albuminuria in patients under age 60 with insulin dependent diabetes mellitus (IDDM) complicated by hypertension. Among 469 patients regularly being followed for IDDM 76 were found with treated/un treated hypertension (16.2%). 62 patients from this group were investigated for urinary albumin excretion rate (AER) (24-hour timed urine collection, three times, immunoturbidimetric method). Microalbuminuria (AER 30–300 mg/day) was detected in 15 cases (24%), macroalbuminuria (AER>300 mg/day) in 11 patients (18%), whereas in 36 cases no abnormal albuminuria (AER<30 mg/day) was found. No significant differences have been found in age, duration of diabetes or metabolic control (HbA1c) among the investigated groups. The longest duration of hypertension though not statistically significant, was observed in the normoalbuminuric group. The ratio of treated/untreated patients with hypertension in normo-, micro- and macroalbuminuric groups were as follows: 23/13, 12/3 and 11/0 respectively. The maximal systolic and diastolic blood pressure values in the macroalbuminuric group, however, significantly surpassed that of the normoalbuminuric group (p<0.01). One third of normoalbuminuric patients with hypertension had no alteration in their eye-fundi. The prevalence of proliferative retinopathy and blindness rose with increasing albuminuria. These results suggest that hypertension developing in IDDM is pathogenetically heterogenous. In a significant number of IDDM patients, hypertension does not follow but rather preceeds development of incipient nephropathy. Hypertension without micro albuminuria in IDDM probably represents essential hypertension with a better prognosis related to the late complications of diabetes.]

AFFILIATIONS

  1. Semmelweis Orvostudományi Egyetem, I. Belgyógyászati Klinika, Budapest
  2. Szent Imre Kórház II. Belosztály, Budapest
  3. Orvostovábbképző Egyetem Szemészeti Klinika, Budapest

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[In spite of the unifying intentions on the nomenclature of congenital anomalies the problem is still considered to be unsolved internationally. Contradictions among each classifications are mainly based on the different viewpoints of practice and scientific researchers. The authors present here a proposition of nomenclature that fits the recommendations of the major international scientific committees but, as a synthesis, they are trying to give a role to etiopathogenesis as well as clinical presentation of congenital abnormalities in their classification. They intended to make this classification to give a proper nomenclature to everyday practice and scientific research work, too.]

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[The patency of the vessel leading to infarction at 60 min was 71.8% in the rscu-PA group and 48% in the streptokinase-treated group (p < 0.001). At 90 min, the same values were 71.2% and 63.9%, respectively (p = 0.15). Between 24 and 36 h, reocclusion of the vessel occurred in 6/121 cases treated with rscu-PA and 5/114 cases treated with streptokinase. At the end of thrombolytic treatment, fibrinogen concentrations decreased to 0.44 g/l for rscu-PA injection and 0.17 g/l for streptokinase administration. The incidence of bleeding complications was significantly lower after rscu-PA treatment than after streptokinase (p<0.01).]

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