Identifying patients with incipient diabetic nephropathy: should 24-hour urine collections be used?

Article Abstract:

Microalbuminuria, the presence of small amounts of blood proteins, particularly albumin, in the urine, is a good indicator of kidney disease in type I or insulin-dependent diabetes. The persistence of microalbuminuria, indicated by an albumin excretion rate (AER) of 20 to 200 micrograms per minute, is associated with incipient or developing kidney disease. The usefulness of 24-hour urine samples to identify diabetic patients with kidney disease has not been determined. Hence, the daytime and overnight AER were measured in 16 type I diabetics with normal AER, 12 diabetics with incipient kidney disease, 12 diabetics with clinical nephropathy (kidney disease), and 24 healthy subjects. AER was decreased at night in all subjects, but varied widely during the day for certain patients in each group. The 24-hour urine collections were more useful than the overnight urine collections in classifying diabetic patients for kidney disease; each patient was correctly classified using the 24-hour sample. The results show that collection of urine over a 24-hour period for testing of albumin levels is more sensitive than overnight urine sampling in identifying patients with incipient diabetes-related kidney disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Diagnosis, Testing, Diabetic nephropathies, Kidney diseases, Urine, Urinalysis, Albuminuria

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Cystometric evaluation of bladder dysfunction in elderly diabetic patients

Article Abstract:

The underlying cause of urinary incontinence, the inability to retain urine, should be determined before a treatment is selected. Urinary incontinence in diabetes may result from autonomic neuropathy, or disease of the autonomic nervous system, which controls involuntary body functions such as urination. Cystometry, which measures bladder capacity and the pressure changes within the bladder during urination, was performed on 23 elderly diabetic patients with symptoms of impaired urinary function. Contractions of the bladder muscle were found to be involuntary in 61 percent of patients, normal in 13 percent, of low magnitude in 17 percent, and absent in 9 percent. Seventy-six percent of the patients with urinary incontinence had involuntary bladder muscle contractions, whereas those patients with urinary retention, or difficulty urinating, had either low-magnitude voluntary contractions or no bladder contractions. These findings indicate that impaired urinary function is not always associated with poor contractions of the bladder muscle. Cystometry and examination of bladder function are useful in selecting therapy for elderly diabetic patients with impaired urinary function. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Causes of, Urinary incontinence, Bladder, Urination disorders

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