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      Reduction in Mean Glomerular Pore Size Coincides with the Development of Large Shunt Pores in Patients with Diabetic Nephropathy

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          Abstract

          The glomerular size selectivity was determined by neutral dextran clearance sieving technique and plasma cystatin C levels in two groups of patients with long-standing type I diabetes mellitus and different stages of albuminuria but normal glomerular filtration rate and in a group of healthy controls. The sieving characteristics of the glomerular filter were determined using a mathematical model of log normal pore size distribution. Patients with albuminuria above 200 μg/min exhibited a significant increase of cystatin c plasma concentrations and a significant reduction in mean glomerular filtration slit size. Only these patients exhibited large, unrestrictive pores in the glomerular filter (shunt). The plasma cystatin c levels correlated significantly with 26-angstrom neutral dextran plasma levels in microalbuminuric patients and in patients with albuminuria above 200 μg/ min. We conclude that a reduction in average pore size of the glomerular filter does not occur earlier than the development of large shunt pores. The renal clearance of cystatin c in patients with proteinuric diabetic nephropathy but a normal glomerular filtration rate is reduced due to its molecular size.

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          Author and article information

          Journal
          EXN
          Nephron Exp Nephrol
          10.1159/issn.1660-2129
          Cardiorenal Medicine
          S. Karger AG
          1660-2129
          2001
          October 2000
          06 October 2000
          : 9
          : 1
          : 49-53
          Affiliations
          aDepartment of Internal Medicine III, Division of Nephrology and Dialysis, and bClinical Institute for Medical and Chemical Laboratory Medicine, University of Vienna, Austria; cDepartment of Internal Medicine, Division of Nephrology, University of Varna, Bulgaria
          Article
          20698 Exp Nephrol 2001;9:49–53
          10.1159/000020698
          11053980
          © 2000 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
          Figures: 2, Tables: 3, References: 14, Pages: 5
          Product
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/20698
          Categories
          Original Paper

          Cardiovascular Medicine, Nephrology

          Nephropathy, Diabetes, Cystatin c, Albuminuria, Permselectivity, Dextran

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