The coefficient of variation of AER was 37.7%, 66% and 94.8% for subjects with persistent, intermittent and progressing normoalbuminuria 43%, 70.6%, 86.1% and 82.3% for subjects with persistent, intermittent, progressing and regressing microalbuminuria and 55.2%, 67% and 82.4% for subjects with persistent, intermittent and regressing macroalbuminuria, respectively. The median coefficient of variation of AER was 53.3%, 76.0% and 67.0% for subjects with normo-, micro- or macroalbuminuria at baseline. Coefficients of variation were used to measure intra-individual AER variability.

Participants were then categorised into four patterns of AER trajectories: persistent, intermittent, progressing and regressing. Participants were categorised as having normo-, micro- or macroalbuminuria according to their initial three AER measurements. Baseline clinical characteristics were collected to determine associations with AER variability. MethodsĬonsecutive AER measurements (median 19 per subject) were performed in 497 participants with type 2 diabetes from 1999 to 2012 (mean follow-up 7.9 ± 3 years). Nevertheless, it is important to investigate the long-term intra-individual variability of AER in participants with type 2 diabetes. There are recognised limitations of using AER as a marker of DKD because one quarter of patients with type 2 diabetes may develop kidney disease without an increase in albuminuria and spontaneous regression of albuminuria occurs frequently. An important method for evaluating risk of progressive DKD is abnormal albumin excretion rate (AER).ĭue to the high variability in AER, most guidelines recommend the use of more than or equal to two out of three AER measurements within a 3- to 6-month period to categorise AER. Early and accurate identification of DKD offers the best chance of slowing the progression of kidney disease.

Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease in the Western world.

Albuminuria macro vs micro