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Importance of low-Grade Albuminuria
The importance of low grade albuminuria is changing the world of understanding of the complications of diabetes.
Throughout my career I believed and understood from all my teachers that chronic diabetes renal disease begins in kidneys.
Cardiovascular disease was typically thought to originate and to progress as a separate entity. As these things are looked at today, it seems that these beliefs are entirely reversed. It is cardiovascular disease that is beginning and the kidney is best thought of as a ball of blood vessels, large and small, that get included in the vessels undergoing accelerated atherosclerosis so characteristic of diabetes.
The urinary albumen excretion is now accepted as an important marker for developing cardiovascular disease. The traditional upper limit of protein in the urine is 30 milligrams per deciliter. The levels above this but lower than a gram is microalbuminuria.
This association of protein excretion and cardiovascular disease is independent of kidney function. The treatment in my office is valsartan and an l-arginine complex ProArgi9 plus® that seems to quickly reverse this clinical situation.
Mayo Clinic Proc. July 2008 ;(7):806-812
Monday, September 29, 2008
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