Microalbuminuria and Diabetic Pregnancy

  • Carl Erik Mogensen
  • Joachim G. Klebe

Abstract

Renal and vascular damage, including blood pressure elevation, is often involved in complications of diabetic pregnancy. Therefore, sensitive methods for measuring elevated urinary protein excretion, especially of albumin (so-called microalbuminuria) [1–3], might be useful in early prediction of complications in diabetic as well as nondiabetic pregnancy. This is the case in nonpregnant diabetics [3–9], in whom microalbuminuria is a sensitive marker of generalized subclinical vascular disturbance and damage [6] and in whom it predicts overt nephropathy [3–6] as well as proliferative retinopathy [7]. This chapter deals with the pattern of urinary albumin excretion rate in diabetic pregnancy as studied with a sensitive radioimmunoassay for albumin using 24-h urine samples. Patients with overt nephropathy are discussed in Chapter 37.

Keywords

Diabetic Nephropathy Mean Arterial Pressure Proliferative Diabetic Retinopathy Urinary Albumin Excretion Urinary Albumin Excretion Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Mogensen CE. Microalbuminuria as a predictor of clinical diabetic nephropathy. Kidney Int 1987; 31: 673–689.PubMedCrossRefGoogle Scholar
  2. 2.
    Viberti GC, Mackintosh D, Bilous RW, Pickup JC, Keen H. Proteinuria in diabetes mellitus: role of spontaneous and experimental variation of glycaemia. Kidney Int 1982; 21: 714–720.PubMedCrossRefGoogle Scholar
  3. 3.
    Mogensen CE, Christensen CK. Predicting diabetic nephropathy in insulin-dependent patients. N Engl J Med 1984; 311: 89–93.PubMedCrossRefGoogle Scholar
  4. 4.
    Viberti GC, Hill RD, Jarrett RJ, Argyropoulos A, Mahmud U, Keen H. Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet 1982; 1: 1430–1432.PubMedCrossRefGoogle Scholar
  5. 5.
    Parving H-H, Oxenbell B, Svendsen PAa, Christiansen JS, Andersen AR. Early detection of patients at risk of developing diabetic nephropathy: a longitudinal study of urinary albumin excretion. Acta Endocrinol (Copenh) 1982; 100: 550–555.Google Scholar
  6. 6.
    Mathiesen ER, Oxenboll B, Johansen K, Svendsen PAa, Deckert T. Incipient nephropathy in type 1 (insulin-dependent) diabetes. Diabetologia 1984; 26: 406–410.PubMedCrossRefGoogle Scholar
  7. 7.
    Vigstrup J, Mogensen CE. Proliferative diabetic retinopathy: at risk patients identified by early detection of microalbuminuria. Acta Ophthalmol 1985; 63: 530–534.Google Scholar
  8. 8.
    Feldt-Rasmussen B. Increased transcapillary escape rate of albumin in type 1 (insulin-dependent) diabetic patients with microalbuminuria. Diabetologia 1986; 29: 282–286.PubMedCrossRefGoogle Scholar
  9. 9.
    Feldt-Rasmussen B, Mathiesen E, Deckert T. Effect of two years of strict metabolic control on the progression of incipient nephropathy in insulin-dependent diabetes. Lancet 1986; 2: 1300–1304.PubMedCrossRefGoogle Scholar
  10. 10.
    Miles DW, Mogensen CE, Gundersen HJG. Radioimmunoassay for urinary albumin using a single antibody. Scand J Clin Lab Invest 1970; 26: 5–11.PubMedCrossRefGoogle Scholar
  11. 11.
    Mogensen CE. Microalbuminuria and kidney function in diabetes: Notes on methods, interpretation and classification. In: Clarke WL, Lamer J, Pohl SL (eds). Methods in Diabetes Research, volume II: Clinical Methods. New York, Chichester, Brisbane, Toronto, Singapore: John Wiley & Sons; 1986; pp. 611–631.Google Scholar
  12. 12.
    Mogensen CE, Chachati A, Christensen CK, Close CF, Deckert T, Hommel E, Kastrup J, Lefebvre P, Mathiesen ER, Feldt-Rasmussen B, Schmitz A, Viberti GC. Microalbuminuria: an early marker of renal involvement in diabetes. Uremia Invest 1985–86; 9: 85–95.PubMedGoogle Scholar
  13. 13.
    Pedersen EB, Rasmussen AB, Johannesen P, Lauritsen JG, Kristensen S, Mogensen CE, Selling K, Wohlert M. Urinary excretion of albumin, beta-2-microglobulin and light chains in preeclampsia, essential hypertension in pregnancy and normotensive pregnant and non-pregnant control subjects. Scand J Clin Lab Invest 1982; 41: 777–784.CrossRefGoogle Scholar
  14. 14.
    Lopez-Espinoza I, Dhar H, Humphreys S, Redman CWG. Urinary albumin excretion in pregnancy. Br J Obstet Gynaecol 1986; 93: 176–181.PubMedCrossRefGoogle Scholar
  15. 15.
    Irgens-Meller L, Hemmingsen L, Holm J. Diagnostic value of microalbuminuria in preeclampsia. Clin Chim Acta 1986; 157: 295–298.CrossRefGoogle Scholar
  16. 16.
    Freinkel N, Dooley SL, Metzger BE. Care of the pregnant woman with insulin-dependent diabetes mellitus. N Engl J Med 1985; 131: 96–101.CrossRefGoogle Scholar
  17. 17.
    Pedersen J. The pregnant diabetic and her newborn, 2nd ed. Copenhagen: Munksgaard; 1977.Google Scholar
  18. 18.
    Redman DWG. The definition of pre-eclampsia. Scand J Clin Lab Invest 1984; 44: suppl. 169: 7–14.CrossRefGoogle Scholar
  19. 19.
    Gregorini G, Perico N, Remuzzi G: 2. Pathogenesis of preeclampsia. In: Andreucci VE (ed). The Kidney in Pregnancy. Boston: Martinus Nijhoff; 1986; pp. 13–33.CrossRefGoogle Scholar
  20. 20.
    Mogensen CE, Poulsen PL, Heinsvig EM. Abnormal albuminuria in the monitoring of early renal changes in diabetes. In: Mogensen CE, Standi E (eds). Concepts for the Ideal Diabetes Clinic. Diabetes Forum Series, Volume 4. Berlin, New York: Walter de Gruyter; 1993; pp. 289–313.Google Scholar
  21. 21.
    Klebe JG, Mogensen CE, Christensen T. Nephropathy in Pregnancy. In: Sutherland HW, Stowers JM, Pearson DWM (eds). Carbohydrate Metabolism in Pregnancy and the Newborn IV. London, Berlin, Heidelberg, New York, Paris, Tokyo: Springer Verlag; 1989; pp. 173–187.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Carl Erik Mogensen
  • Joachim G. Klebe

There are no affiliations available

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