ORIGINAL ARTICLES Microalbuminuria in Diabetic Adolescents and Children—Feasibility Phase of a National Cross-Sectional Study Theresa H. Moore Julian P. Shield on behalf of the MIDAC Research Group* ABSTRACT Our objective was to assess the feasibility of total of 419 patients were recruited to the study from ten centers of whom 308 (74%) correctly provided examining the prevalence of microalbuminuria nationally and to validate the effectiveness of the three timed overnight urine samples; 13 patients (4.2%) were microalbuminuric (AER  20 gmin -1 collection and central analysis of biological specimens. In a centrally coordinated, cross- in at least two of three urine samples), 1 (0.3%) was proteinuric (AER  200 gmin -1 in at least sectional, multicenter pilot study in pediatric, diabetes outpatients clinics in UK and the Republic two of three urine samples). All patients found to have microalbuminuria and proteinuria were of Ireland, blood and urine samples were collected from patients aged between 10 and 20 years, with pubertal or post-pubertal. This study demonstrates that it is possible to coordinate a network of a duration of insulin-dependent diabetes greater than 1 year attending diabetes outpatient clinics, centers in the United Kingdom and the Republic of Ireland for the purposes of diabetes research in between April 1996 and February 1997. These samples were analyzed at a central reference young adults and children. The level of abnormal albumin excretion of 4.5% is less than previously laboratory for HbA 1C using high performance liquid chromatography (HPLC) and for urinary described in such age groups in other countries. ( Journal of Diabetes and Its Complications 13; 3: albumin and creatinine concentrations using spectrophotometry. Clinical data were collected 122–128, 1999.)  1999 Elsevier Science Inc. locally and sent to the coordinator for analysis. A INTRODUCTION thy. 2–4 The prognosis for diabetic patients with overt nephropathy is very poor, with 50% dying within 7 M icroalbuminuria has long been described years. 5 Recent studies have, however, suggested a more as predictive of overt nephropathy in in- limited predictive value for microalbuminuria, with sulin-dependent adults with diabetes, 1 only 50% of cases progressing to overt diabetic ne- with claims that over 80% of those with phropathy. 6,7 persistent microalbuminuria develop overt nephropa- Initial studies on microalbuminuria in childhood dia- betes indicated prognostic inconsistencies cautioning against extrapolation from studies of microalbuminu- * See Appendix. ria in adults. 8–10 MIDAC Research Group, Division of Child Health, University of In order to clarify the significance of microalbuminu- Bristol, Royal Hospital for Sick Children, Bristol, United Kingdom Reprint requests to be sent to: Theresa H. Moore, MIDAC Research ria in children with diabetes, a prospective, longitudi- Co-ordinator, Division of Child Health, University of Bristol, Royal nal study of prevalence and progression is needed. Hospital for Sick Children, St. Michael’s Hill, Bristol, BS2 8BL, United Kingdom. This paper reports the results of the feasibility study Journal of Diabetes and Its Complications 1999; 13:122–128  1999 Elsevier Science Inc. All rights reserved. 1056-8727/99/$–see front matter 655 Avenue of the Americas, New York, NY 10010 PII S1056-8727(99)00033-1