Increased cardiovascular risk among type 2 diabetic patients with high-normal albuminuria and no evidence of kidney impairment

Mounting evidence indicates that albuminuria in the ‘high-normal’ range is a predictor of cardiovascular morbidity and mortality . Which factors account for this increased risk and whether such a prediction is maintained even in the absence of a concomitant reduction of glomerular filtration rate (GFR) is unclear. To address this issue more in depth in the context of type 2 diabetes (T2D), we conducted a cross-sectional study of a cohort comprising 1148 (556 males/592 females) patients with T2D, age 60.4 ± 10 years, duration of diabetes 10.5 ± 9 years, with normoalbuminuria (male: albumin/creatinine ratio (ACR) = 0.72 (0.01–2.45); female: ACR = 0.88 (0.01–3.49) mg mmol −1 ) and no evidence of kidney impairment [e-GFR (MDRD) 89.5 ± 21 ml min −1 1.73 m −2 )