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Diagnostics
Volume 11
Issue 2
10.3390/diagnostics11020290
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Review

Role of Albuminuria in Detecting Cardio-Renal Risk and Outcome in Diabetic Subjects

by
Pia Clara Pafundi
1,†,
Carlo Garofalo
1,†,
Raffaele Galiero
1,†,
Silvio Borrelli
1,
Alfredo Caturano
1,
Luca Rinaldi
1,
Michele Provenzano
2,
Teresa Salvatore
3,
Luca De Nicola
1,
Roberto Minutolo
1,*,‡ and
Ferdinando Carlo Sasso
1,*,‡
1
Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Luigi Miraglia 2, 80138 Naples, Italy
2
Renal Unit, Department of Health Sciences, “Magna Graecia” University, Viale Europa, 88100 Catanzaro, Italy
3
Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via De Crecchio 7, 80138 Naples, Italy
*
Authors to whom correspondence should be addressed.
†
R.G., P.C.P. and C.G. (co-first authors) equally contributed to the draft of the manuscript.
‡
R.M. and F.C.S. are co-last and co-corresponding authors.
Diagnostics 2021, 11(2), 290; https://doi.org/10.3390/diagnostics11020290
Submission received: 28 January 2021 / Revised: 9 February 2021 / Accepted: 10 February 2021 / Published: 12 February 2021
(This article belongs to the Special Issue Cardio-Renal Metabolic Syndrome: Interdisciplinary Diagnostic Methods)
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Abstract

The clinical significance of albuminuria in diabetic subjects and the impact of its reduction on the main cardiorenal outcomes by different drug classes are among the most interesting research focuses of recent years. Although nephrologists and cardiologists have been paying attention to the study of proteinuria for years, currently among diabetics, increased urine albumin excretion ascertains the highest cardio-renal risk. In fact, diabetes is a condition by itself associated with a high-risk of both micro/macrovascular complications. Moreover, proteinuria reduction in diabetic subjects by several treatments lowers both renal and cardiovascular disease progression. The 2019 joint ESC-EASD guidelines on diabetes, prediabetes and cardiovascular (CV) disease assign to proteinuria a crucial role in defining CV risk level in the diabetic patient. In fact, proteinuria by itself allows the diabetic patient to be staged at very high CV risk, thus affecting the choice of anti-hyperglycemic drug class. The purpose of this review is to present a clear update on the role of albuminuria as a cardio-renal risk marker, starting from pathophysiological mechanisms in support of this role. Besides this, we will show the prognostic value in observational studies, as well as randomized clinical trials (RCTs) demonstrating the potential improvement of cardio-renal outcomes in diabetic patients by reducing proteinuria.
Keywords: type 2 diabetes; albuminuria; cardiovascular risk; renal outcome type 2 diabetes; albuminuria; cardiovascular risk; renal outcome

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MDPI and ACS Style

Pafundi, P.C.; Garofalo, C.; Galiero, R.; Borrelli, S.; Caturano, A.; Rinaldi, L.; Provenzano, M.; Salvatore, T.; De Nicola, L.; Minutolo, R.; et al. Role of Albuminuria in Detecting Cardio-Renal Risk and Outcome in Diabetic Subjects. Diagnostics 2021, 11, 290. https://doi.org/10.3390/diagnostics11020290

AMA Style

Pafundi PC, Garofalo C, Galiero R, Borrelli S, Caturano A, Rinaldi L, Provenzano M, Salvatore T, De Nicola L, Minutolo R, et al. Role of Albuminuria in Detecting Cardio-Renal Risk and Outcome in Diabetic Subjects. Diagnostics. 2021; 11(2):290. https://doi.org/10.3390/diagnostics11020290

Chicago/Turabian Style

Pafundi, Pia Clara, Carlo Garofalo, Raffaele Galiero, Silvio Borrelli, Alfredo Caturano, Luca Rinaldi, Michele Provenzano, Teresa Salvatore, Luca De Nicola, Roberto Minutolo, and et al. 2021. "Role of Albuminuria in Detecting Cardio-Renal Risk and Outcome in Diabetic Subjects" Diagnostics 11, no. 2: 290. https://doi.org/10.3390/diagnostics11020290

APA Style

Pafundi, P. C., Garofalo, C., Galiero, R., Borrelli, S., Caturano, A., Rinaldi, L., Provenzano, M., Salvatore, T., De Nicola, L., Minutolo, R., & Sasso, F. C. (2021). Role of Albuminuria in Detecting Cardio-Renal Risk and Outcome in Diabetic Subjects. Diagnostics, 11(2), 290. https://doi.org/10.3390/diagnostics11020290

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