0
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found

      Renal Function and Renal Function Reserve in Insulin-Dependent Diabetic Patients during (Near) Normoglycaemia

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Twenty-three normoalbuminuric (N) and 7 microalbuminuric (M) insulin-dependent diabetes mellitus (IDDM) patients were studied under (near) normoglycaemic conditions. They were reasonably well controlled during the period preceding the renal function test (HbA<sub>1</sub>: N = 7.6 ± 1.3%, M = 8.0 ± 2.2%; normal < 6.0%). Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured using the clearances of <sup>125</sup>I-thalamate and <sup>131</sup>I-hippuran, respectively. The renal reserve filtration capacity (RRFC) was tested by using a combination of a liquid mixed meal and an amino acid infusion. Blood glucose levels were kept as constant as possible throughout the testing procedure, both under baseline (BL) conditions and after stimulation (S). Under such (near) normoglycaemic conditions, no BL GFR values exceeding 150 ml/min/1.73 m<sup>2</sup> could be established. Furthermore, a RRFC could be established in all patients. Both groups showed a comparatively larger increase in GFR (N 13.0 ± 3.8%, M 10.8 ± 3.6%) than in ERPF (N 4.8 ± 7.0%, M 2.2 ± 5.8%; %Δ GFR vs. % ΔERPF p < 0.01), resulting in a higher filtration fraction (FF) during stimulation (N: BL FF 0.25 ± 0.03 vs. S FF 0.27 ± 0.03, p < 0.0l; M: BL FF 0.25 ± 0.01 vs. S FF 0.27 ± 0.01, p < 0.05). This suggests afferent vasodilation during stimulation in these (near) normoglycaemic, reasonably well-controlled IDDM patients, a situation comparable to that in non-diabetic subjects. Thus, reasonably well-controlled normoglycaemic N or M IDDM patients appear to have a (virtually) normal renal function, a normal renal vascular reactivity, and a normal RRFC. In our opinion, these results emphasize the importance of strict metabolic control in IDDM patients to prevent continuous afferent vasodilation and hyperfiltration.

          Related collections

          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1991
          1991
          11 December 2008
          : 58
          : 3
          : 295-299
          Affiliations
          Departments of Internal Medicine, aFree University Hospital, Amsterdam, bde Weezenlanden Hospital, Zwolle, and cStichting Samenwerkende Deventer Ziekenhuizen, Deventer, The Netherlands
          Article
          186439 Nephron 1991;58:295–299
          10.1159/000186439
          1896094
          © 1991 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 5
          Categories
          Original Paper

          Comments

          Comment on this article