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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe current worldwide prevalence of diabetes is estimated to be 366 million. One-third of these cases progress to nephropathy, a major cause of cardiovascular disease and end-stage renal disease. This article describes the prevalence, incidence, and progression of nephropathy and identified demographic and clinical characteristics that are associated with progression in a US population-based sample.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ERenal Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Kidney Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe current worldwide prevalence of diabetes is estimated to be 366 million. One-third of these cases progress to nephropathy, a major cause of cardiovascular disease (CVD) and end-stage renal disease (ESRD). Progression through stages of nephropathy has not been well described in a large, well-characterized, population-based study. Suma Vupputuri, PhD, The Center for Health Research, Kaiser Permanente Georgia, Atlanta, Georgia, USA, described the prevalence, incidence, and progression of nephropathy and identified demographic and clinical characteristics that are associated with progression in a US population-based sample.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EA total of 11,562 members of a managed care organization (Kaiser Permanente), aged 18 years and older, with hypertension and type 2 diabetes, a urine-to-albumin creatinine ratio (UACR) measurement during 2001\u20132003, and at least one follow-up UACR, were independently assessed for different stages of nephropathy. Three baseline stages of nephropathy were defined: normal albumin (\u0026lt;30 \u03bcm\/mg), microalbuminuria (30\u2013299 \u03bcm\/mg), and macroalbuminuria (\u2265300 \u03bcm\/mg). Records through 2008 were searched for individuals who showed progression from baseline to a higher stage of nephropathy, including ESRD. Progression was defined as the first UACR value that was recorded in a stage that was higher than baseline. Incidence was calculated as the number of new cases over the sum of the person-time of the at-risk population. Independent predictors of time to progression were assessed using Cox regression.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EAt baseline, 59% of subjects had normal albumin (n=6853), 30% had microalbuminuria (n=3492), and 11% had macroalbuminuria (n=1217). The incidence of nephropathy progression (per 1000 person-years) was 94.6, 44.1, and 6.7 for normal albumin, microalbuminuria, and macroalbuminuria, respectively. \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E shows the number of patients who progressed to higher stages of nephropathy.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/11527\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/11527\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11527\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003EPrevalence of Nephropathy and Progression to Subsequent Stages.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EPredictors of progression of nephropathy included age (per 5 years), race (Caucasian), diabetes duration (per year), systolic and diastolic blood pressure (per 5 mm Hg), HbA1C (per 1%), body mass index (per 5 kg\/m\u003Csup\u003E2\u003C\/sup\u003E), estimated glomerular filtration rate (per 10 mL\/min\/1.73m\u003Csup\u003E2\u003C\/sup\u003E), use of ACE inhibitors\/ARBs, CVD, and active heart failure.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EAlthough the ability to extend the results of this study to a broader population may be limited by the study sample (ie, only patients with diabetes and hypertension who had health insurance were included), Dr. Vupputuri concluded that in one of the first studies to examine the progression of nephropathy in a US population-based sample of adults with diabetes and hypertension, the lifetime risk of nephropathy and its progression may be greater than previously reported. Developing strategies to slow and\/or prevent the progression of nephropathy may reduce the burden of disease.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2010 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/10\/9\/22.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmnw3\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzmnw3\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}