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Fecal neutral and acidic sterols and cholesterol absorption were measured in 12 normal control subjects, 40 diabetic subjects with and without hyperlipidemia, and 27 subjects with hyperlipidemia but without diabetes mellitus. All subjects were on a low-cholesterol diet (less than 300 mg cholesterol/day). Fecal excretion of neutral and acidic sterols was increased in patients with hypertriglyceridemia and was more marked in diabetic patients with hypertriglyceridemia. Cholesterol absorption was decreased in diabetic patients with hypertriglyceridemia. Otherwise, there were no significant differences in sterol excretion or cholesterol absorption in diabetic and nondiabetic subjects compared with control groups with similar lipid levels. The best predictors of fecal neutral- and acidic-sterol excretion and of estimated cholesterol synthesis were very low [corrected]-density lipoprotein triglycerides and high-density lipoprotein cholesterol. Correction of hyperlipidemia may be beneficial in decreasing cholesterol synthesis and, thereby, in decreasing the risk of atherogenesis.

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Currently used contrast media for excretory urography are generally considered safe even in the presence of renal insufficiency. Isolated reports of acute oliguric renal failure in diabetic patients after excretory urography have been documented. We describe eight such patients who developed this complication. The approximate incidence of recognized acute oliguric renal failure in diabetics undergoing excretory urography was 2 in 1000 as compared with none in more than 100 000 procedures done in nondiabetic patients. Six of the diabetic patients with acute renal failure recovered; two required hemodialysis, never regaining self-sustaining renal function. If detected early, acute renal failure in this setting can often be managed conservatively. Attempts to induce diuresis have been discouraging.