Albumin excretion rate is not affected by asymptomatic urinary tract infection: A prospective study

Abstract

OBJECTIVE - The aim of the study was to evaluate whether asymptomatic urinary tract infection (UTI) significantly influences the level of albumin excretion rate (AER) in diabetic patients. RESEARCH DESIGN AND METHODS - We screened prospectively for UTI and AER in 765 type 2 diabetic subjects. AER was determined before and after antimicrobial therapy in those patients in whom an asymptomatic UTI was diagnosed (n = 59). To interpret the clinical significance of AER changes, the coefficient of biological variation (CVb) of the AER (CVb-AER) was assessed in a control group of type 2 diabetic patients without UTI (n = 56). RESULTS - AER did not change after antimicrobial treatment either in the whole group of patients with UTI (pre: 13.8 μg/min [0.1-195] vs. post: 8.5 μg/min [0.1-185]; P = 0.1) or in those patients in whom the infection was eradicated (pre: 11.7 μg/min [0.1-195] vs. post: 7.1 μg/min [0.1-185]; NS). The CVb-AER was 64% in the control group and was inversely correlated with AER (r = -0.44; P = 0.001). The decrease of AER after antimicrobial therapy (55%) did not exceed the biological variation of AER (64%). Finally, UTI did not significantly influence the classification of diabetic patients as normo- or microalbuminuric. CONCLUSIONS - Asymptomatic UTI does not increase AER in type 2 diabetic patients. Therefore, our results suggest that testing for UTI is not necessary when AER is measured in diabetic patients.