Proteinuria in African Americans with type 1 diabetes

Aims: African Americans with type I diabetes are at a high risk for end-stage renal disease (ESRD). Factors associated with the presence of (any) proteinuria were examined in this ethnic group. Methods: Proteinuria and creatinuria were measured in both first-voided and 4-h timed urine specimens in African Americans with type 1 diabetes (N= 717). Other evaluations included clinical interview, ocular examination, fundus photography, blood pressure, and glycosylated hemoglobin measurements. Results: Of the 717 patients, 357 (49.8%) had an); proteinuria. Frequency of any proteinuria increased significantly with (a) age, from 34.2% of patients 20-30 years of age to 84.7% in those > 45 years of age, and (b) duration of diabetes from 24.1% in those with 0-4 years of diabetes to 77.5% in those with > 25 years of diabetes. Multivariate logistic regression showed that any proteinuria was significantly and independently associated with male sex, systemic hypertension.. poor glycemic control, and longer duration of diabetes. Conclusion: Proteinuria is common in African Americans with type I diabetes. Risk factors include male sex, systemic hypertension, poor glycemic control, and longer duration of diabetes. Whether early protection of renal function, in addition to glycemic control, may prevent such morbidity in this ethnic group requires study. (C) 2004 Elsevier Inc. All rights reserved.