Albuminuria changes and clinical outcomes in T1D

What is it about?

This study is a secondary analysis of the DCCT/EDIC cohort of type 1 diabetes. It examines whether changes in urinary albumin excretion are associated with subsequent health outcomes related to the kidneys and cardiovascular system.

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Why is it important?

Greater excretion of albumin in the urine (albuminuria) is known to be strongly associated with the development of clinical kidney and cardiovascular disease. Because these associations are very strong, many people have advocated targeting clinical treatments to albuminuria level, for example adding new medications or increasing doses of medications when albuminuria is higher than desired. Some observational studies have suggested that this might be a good idea, specifically in the setting of type 2 diabetes with very high urine albumin excretion. In this study, we found that reductions in albuminuria from the "microalbuminuria" range to the normal range in type 1 diabetes were not associated with better kidney or cardiovascular outcomes. The implication is that clinicians and patients with type 1 diabetes might not want to change their treatment plan to reduce urine albumin excretion when it's in the microalbumionuria range, if standard treatments like glucose and blood pressure control have already been applied.