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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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          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

          Nephron Exp Nephrol
          Cardiorenal Medicine
          S. Karger AG
          October 2000
          06 October 2000
          : 9
          : 1
          : 49-53
          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
          20698 Exp Nephrol 2001;9:49–53
          © 2000 S. Karger AG, Basel

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          Page count
          Figures: 2, Tables: 3, References: 14, Pages: 5
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/20698
          Original Paper

          Cardiovascular Medicine, Nephrology

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


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