Microalbuminuria, insulin resistance, diabetes, hypertension, and kidney function: the latest concepts in pathology and pharmacologic treatment.

Yousri M. Barri, Biff F. Palmer, C. Venkata S Ram

Research output: Contribution to journalArticle

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Abstract

Microalbuminuria-increased urinary albumin excretion undetectable by traditional urinary dipstick-has been associated with insulin resistance, diabetes mellitus, obesity, and hypertension. It is also a powerful predictor for heart disease and all-cause mortality. In diabetic patients, microalbuminuria has been correlated with the progression of diabetic nephropathy and the development of renal insufficiency. Furthermore, its correlation with markers of inflammation such as C-reactive protein suggests that microalbuminuria may indicate generalized endothelial dysfunction rather than isolated nephropathy. Drugs that block the renin-angiotensin system, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have been shown to reduce albuminuria, resulting in renal protection. Recently, dualaction beta-adrenergic blockers such as carvedilol have been shown to exert favorable effects on albuminuria in diabetic patients with hypertension. Insulin resistance reflects a predictable risk for diabetes, and there appears to be a good correlation between insulin resistance, albuminuria, and progression of renal disease in diabetes with or without hypertension. As in microalbuminuria, ACE inhibitors, ARBs, and dual-action beta-blockers help improve insulin sensitivity.

Original languageEnglish (US)
Pages (from-to)34-45
Number of pages12
JournalPostgraduate Medicine
Volume118
Issue number6 Suppl Beta-Blockers
StatePublished - Dec 2005

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Albuminuria
Insulin Resistance
Pathology
Hypertension
Kidney
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Adrenergic beta-Antagonists
Diabetic Nephropathies
Therapeutics
Renin-Angiotensin System
C-Reactive Protein
Renal Insufficiency
Disease Progression
Albumins
Heart Diseases
Diabetes Mellitus
Obesity
Inflammation
Mortality

ASJC Scopus subject areas

  • Medicine(all)

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Microalbuminuria, insulin resistance, diabetes, hypertension, and kidney function : the latest concepts in pathology and pharmacologic treatment. / Barri, Yousri M.; Palmer, Biff F.; Ram, C. Venkata S.

In: Postgraduate Medicine, Vol. 118, No. 6 Suppl Beta-Blockers, 12.2005, p. 34-45.

Research output: Contribution to journalArticle

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