Reduction in Microalbuminuria as an Integrated Indicator for Renal and Cardiovascular Risk Reduction in Patients With Type 2 Diabetes

Reduction in Microalbuminuria as an Integrated Indicator for Renal and Cardiovascular Risk Reduction in Patients With Type 2 Diabetes Shin-ichi Araki 1 , Masakazu Haneda 2 , Daisuke Koya 3 , Hideki Hidaka 4 , Toshiro Sugimoto 1 , Motohide Isono 1 , Keiji Isshiki 1 , Masami Chin-Kanasaki 1 , Takashi Uzu 1 and Atsunori Kashiwagi 1 1 Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan 2 Second Department of Medicine, Asahikawa Medical College, Asahikawa, Hokkaido, Japan 3 Division of Endocrinology and Metabolism, Department of Medicine, Kanazawa Medical School, Kahoku-gun, Ishikawa, Japan 4 Medical and Health Care Center, SANYO Electric Group Health Insurance Association, Moriguchi, Osaka, Japan Address correspondence and reprint requests to Shin-ichi Araki, MD, PhD, Department of Medicine, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan. E-mail: araki{at}belle.shiga-med.ac.jp Abstract OBJECTIVE—Microalbuminuria in diabetic patients is a predictor for diabetic nephropathy and cardiovascular disease. The aim of this study is to investigate the clinical impact of reducing microalbuminuria in type 2 diabetic patients in an observational follow-up study. RESEARCH DESIGN AND METHODS—We enrolled 216 type 2 diabetic patients with microalbuminuria during an initial 2-year evaluation period and observed them for the next 8 years. Remission and a 50% reduction of microalbuminuria were defined as a shift to normoalbuminuria and a reduction