{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T20:11:48Z","timestamp":1785010308227,"version":"3.55.0"},"reference-count":52,"publisher":"American Diabetes Association","issue":"7","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2005,7,1]]},"abstract":"<jats:p>Predictors of albumin excretion rate (AER) abnormalities could provide earlier indicators of diabetic nephropathy risk. Data from the Natural History Study, a prospective 5-year observation of renal structure and function in young type 1 diabetic patients, were examined for predictors of AER patterns in normoalbuminuric type 1 diabetic patients. Included were 170 patients (96 females) (aged 16.7 \u00b1 5.9 years, duration of diabetes 8.0 \u00b1 4.3 years) with normal blood pressure, normoalbuminuria (AER &amp;lt;20 \u03bcg\/min), and eight or more follow-up visits over 5 years. AER, blood pressure, and HbA1c (A1C) were determined quarterly and glomerular filtration rate (GFR) annually. Persistent microalbuminuria (PMA) was defined as 20\u2013200 \u03bcg\/min in two of three consecutive values within 6\u201312 months. Four different AER patterns were identified. Group 1 (n = 99): all values &amp;lt;20 \u03bcg\/min. Group 2 (n = 49): intermittent levels &amp;gt;20 \u03bcg\/min but not meeting microalbuminuria criteria. Group 3 (n = 14): PMA during follow-up but normoalbuminuria at study exit. Group 4 (n = 8): microalbuminuria at study exit. Group 4 (497 \u00b1 95 nm, P &amp;lt; 0.01) and group 3 (464 \u00b1 113 nm, P = 0.03) patients had greater baseline glomerular basement membrane (GBM) width versus group 1 (418 \u00b1 67 nm). Baseline GFR in group 4 (163 \u00b1 37 ml \u00b7 min\u22121 \u00b7 1.73 m\u22122) was higher than group 1 (143 \u00b1 28 ml \u00b7 min\u22121 \u00b7 1.73 m\u22122, P = 0.04). A1C was higher in group 2 (9.0 \u00b1 1.2%) than group 1 (8.4 \u00b1 1.1%, P = 0.008). Thus, greater increases in GBM width and GFR were predictors of PMA. Since 64% of the patients that developed microalbuminuria reverted to normoalbuminuria, the risk of diabetic nephropathy as defined by current microalbuminuria criteria is unclear.<\/jats:p>","DOI":"10.2337\/diabetes.54.7.2164","type":"journal-article","created":{"date-parts":[[2007,3,6]],"date-time":"2007-03-06T19:04:22Z","timestamp":1173207862000},"page":"2164-2171","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":160,"title":["The Early Natural History of Nephropathy in Type 1 Diabetes"],"prefix":"10.2337","volume":"54","author":[{"given":"Julia M.","family":"Steinke","sequence":"first","affiliation":[{"name":"Division of Pediatric Nephrology, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan R.","family":"Sinaiko","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, McGill University, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samy","family":"Suissa","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, McGill University, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanche M.","family":"Chavers","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Mauer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the International Diabetic Nephropathy Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031208164923100_R1","doi-asserted-by":"crossref","unstructured":"USDRS 2004 annual data report. 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