One-day survey of albuminuria in diabetic outpatients in Fukuoka Prefecture, Japan. Fukuoka Diabetic Clinic Group.

The prevalences and risk factors of micro- and macroalbuminuria were surveyed in all 927 patients with diabetes mellitus who visited outpatient clinics in 27 hospitals in the Fukuoka prefecture on a designated day. The urinary albumin-creatinine ratio (UAI; mg/g Cr) of spot urine was determined in all patients except those with persistent macroproteinuria. The results were as follows: (1) The prevalences of microalbuminuria (UAI 30-299) and macroalbuminuria (UAI greater than or equal to 300) were 26% and 15%, respectively. (2) Hyperglycemia and high blood pressure synergistically increased the prevalences. (3) The independent risk factors of microalbuminuria were severities of retinopathy and neuropathy, duration of diabetes, blood pressure, and HbA1c, as determined by logistic regression analysis, although the explanation rate was low.

Phosphate depletion with phosphate binder arrests the development of nephropathy in spontaneously hypertensive rats with non-insulin-dependent diabetes mellitus fed a high-protein diet.

The protective effect of phosphate binder (PB) on nephropathy was examined in spontaneously hypertensive rats with non-insulin-dependent diabetes mellitus (NIDDM) fed a high-protein diet. The rats were treated with vehicle or streptozocin neonatally. After 14 weeks, all rats were fed a high-protein diet (50% protein content), and in half of the diabetic rats the diets were supplemented with PB. At 24 weeks, the urinary excretion rate of albumin and kidney weight increased in diabetic rats, but decreased or tended to decrease in diabetic rats treated with PB. The elevation of urinary excretion rate of N-acetyl-beta-D-glucosaminidase, probably due to protein load, was also abolished with PB.