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For patients with T2DM, the presence of microalbuminuria doubles the risk of cardiovascular morbidity and mortality. 137138 As urinary protein levels increase, the incidence of stroke, amputation, neuropathy, and retinopathy is also elevated. 139140141 The clinical consequences of microalbuminuria are related to physical injury to vascular endothelium of the kidney and other end organs. Endothelial cell damage progresses in relation to the degree of microalbuminuria. Endothelial injury results in an increase in the release of renin, an enzyme produced primarily by the juxtaglomerular cells of the kidney. Renin catalyzes the conversion of angiotensinogen into an inactive substance: angiotensin I (A-1) ( Fig.

Bush only to be hit by some unfriendly fire from a fan who landed a well aimed drink. The drenched singer, 64, was jeered loudly by another staunch fan (a suspected Republican), the latest in a series of hecklers who have dogged Streisand's first US tour in 12 years.]