Predicting Diabetic Nephropathy

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To the Editor: We were delighted to read the paper by Professors Mogensen and Christensen (July 12 issue)1; not only do they now recognize the phenomenon of microalbuminuria2 in established insulin-dependent diabetics (which Mogensen previously denied3) but their results confirm two other studies that demonstrate that microalbuminuria is a risk index for clinical diabetic nephropathy.4 , 5 These three studies used different screening procedures, and questions remain: What is the albumin excretion rate that denotes the at-risk state? What conditions of measurement should be used? Mogensen and Christensen argue that the value of 15 μg per minute that they propose . . .