Association of Albuminuria With Intraglomerular Hydrostatic Pressure and Insulin Resistance in Subjects With Impaired Fasting Glucose and/or Impaired Glucose Tolerance

Tsuda, Akihiro; Ishimura, Eiji; Uedono, Hideki; Ochi, Akinobu; Nakatani, Shinya; Morioka, Tomoaki; Mori, Katsuhito; Uchida, Junji; Emoto, Masanori; Nakatani, Tatsuya; Inaba, Masaaki

doi:10.2337/dc18-0718

Cited by 32 publications

(22 citation statements)

References 43 publications

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“…Furthermore, proteinuria was an independent predictor for overhydration in CKD [24]. Intraglomerular hydrostatic pressure was proved to be correlated with urinary albumin excretion [25]. Considering these factors together, we hypothesized that proteinuria and DME may both result from increased hydrostatic pressure and were thus associated with each other.…”

Section: Discussionmentioning

confidence: 96%

Renal Biomarkers for Treatment Effect of Ranibizumab for Diabetic Macular Edema

Lai

Huang

Yang

et al. 2020

Journal of Diabetes Research

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Aims. To investigate the correlations between renal biomarkers and the treatment outcomes of ranibizumab for diabetic macular edema (DME). Methods. This hospital-based study retrospectively enrolled 88 eyes from 67 patients who had received one-year intravitreal ranibizumab treatment for DME. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) at baseline and during the follow-up period were recorded. BCVA and OCT characteristics at baseline and their changes after ranibizumab treatment were compared between different proteinuria and estimated glomerular filtration rate (eGFR) groups. Results. Of the 88 eyes studied, those with moderately increased proteinuria had a thicker central subfield foveal thickness (CFT) and a higher proportion of intraretinal cysts than those with no proteinuria (P=0.012 and 0.045, respectively) at baseline. After one year of ranibizumab treatment, the reduction in CFT was greater in patients with severely increased proteinuria than those with normal to mildly increased proteinuria (P=0.030). On the other hand, patients with an eGFR <30 tended to have poorer visual improvements than those with normal eGFR (P=0.044). Conclusions. After ranibizumab treatment for DME, patients with severe proteinuria tended to gain better anatomical improvement, while those with poor eGFR tended to have poorer visual improvement.

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Section: Discussionmentioning

confidence: 96%

Renal Biomarkers for Treatment Effect of Ranibizumab for Diabetic Macular Edema

Lai

Huang

Yang

et al. 2020

Journal of Diabetes Research

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“…The assessment of renal hemodynamic parameters has been described in detail in former studies [20][21][22][23][24][25]. Briefly, glomerular filtration rate (GFR) and renal plasma flow (RPF) were assessed using the constant-infusion input clearance technique with infusion of inulin (Sinistrin, Inutest ® 25% Amp; Fresenius Kabi, Austria) and para-aminohippuric acid (Sodium-para-aminohippurate Injection ® 10%; Daiichi-Sankyo, Tokyo, Japan), respectively.…”

Section: Assessment Of Renal Hemodynamicsmentioning

confidence: 99%

“…Renal vascular resistance was calculated as mean arterial BP/ renal blood flow × 1,000. Intraglomerular pressure and resistances of the afferent and efferent arterioles were calculated based on the Gomez equation [26], which has been applied in previous studies [21,23,25,27]. tributed parameters, the nonparametric test (Mann-Whitney U test) was used for further analysis.…”

Section: Assessment Of Renal Hemodynamicsmentioning

confidence: 99%

Association of Noise Annoyance with Measured Renal Hemodynamic Changes

Kannenkeril

Jung

Ott

et al. 2021

Kidney Blood Press Res

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Background: Chronic mental stress is recognized as a modifiable risk factor for cardiovascular disease. The aim of this study was to demonstrate that noise annoyance-induced stress is associated with changes in renal hemodynamics. Methods: Renal hemodynamic parameters were measured using steady-state input clearance with infusion of para-aminohippuric acid and inulin in individuals with normal, high normal, and elevated blood pressure. All individuals ranked subjective annoyance due to noise in everyday life on a 7-grade Likert scale. The median of all rankings was used as a cutoff point to divide the group into noise-annoyed and non-noise-annoyed individuals. Different renal hemodynamic parameters were calculated based on the Gomez equation. Results: Noise-annoyed individuals (n = 58) showed lower renal plasma flow (599 ± 106 vs. 663 ± 124 mL/min, p = 0.009), lower renal blood flow (1,068 ± 203 vs. 1,172 ± 225 mL/min, p = 0.047), higher filtration fraction (22.7 ± 3.3 vs. 21.3 ± 3.0, p = 0.012), higher renal vascular resistance (88.9 ± 25.6 vs. 75.8 ± 22.9 mm Hg/[mL/min], p = 0.002), and higher resistance of afferent arteriole (2,439.5 ± 1,253.4 vs. 1,849.9 ± 1,242.0 dyn s−1 cm−5, p = 0.001) compared to non-noise-annoyed individuals (n = 55). There was no difference in measured glomerular filtration rate (133 ± 11.8 vs. 138 ± 15 mL/min, p = 0.181), resistance of efferent arteriole (2,419.4 ± 472.2 vs. 2,245.8 ± 370.3 dyn s−1 cm−5, p = 0.060), and intraglomerular pressure (64.0 ± 3.1 vs. 64.6 ± 3.5 mm Hg, p = 0.298) between the groups. After adjusting for age, renal plasma flow, renal blood flow, and renal vascular resistance remained significantly different between the groups, with a trend in increased afferent arteriolar resistance and filtration fraction. Conclusion: In this study, noise annoyance was associated with reduced renal perfusion attributed to increased renal vascular resistance predominantly at the afferent site. Long-term consequences of this renal hemodynamic pattern due to noise annoyance need to be investigated.

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“…Since direct measurement of glomerular hemodynamics parameters is not feasible in humans, the formulae introduced by Gomez [21] allows indirect assessment of glomerular hemodynamics, as reported previously by others [29][30][31][32][33] and ourselves [24,26,[34][35][36]. The Gomez formulae were calculated according to the original report [21], as described in detail in our previous studies [24,26,34,35].…”

Section: Calculation Of Intrarenal Hemodynamic Parametersmentioning

confidence: 99%

Increased Glomerular Hydrostatic Pressure is Associated with Tubular Creatinine Reabsorption in Healthy Subjects

Tsuda

Ishimura

Machiba

et al. 2020

Kidney Blood Press Res

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Background: Cr is secreted by the proximal tubules and thus Cr clearance (Ccr) can overestimate inulin clearance (Cin). However, in some cases, Ccr can even underestimate Cin. This suggests that Cr could be reabsorbed in the tubuli. We examined the clinical parameters that are associated with tubular Cr reabsorption. Methods: In 80 kidney donor candidates (53.9 ± 13.2 years, 29 males), Cin and para-aminohippuric acid clearance were measured simultaneously. Intrarenal hemodynamic parameters were calculated by Gomez’s formulae. To quantify the secretory component of Ccr (SFcr), it was calculated as follows: SFcr = (Ccr − Cin)/Ccr. Results: Twenty-five subjects (31.3%) showed SFcr values <0. SFcr that correlated significantly and negatively with efferent arteriolar resistance (Re) and glomerular hydrostatic pressure (Pglo) (Re: r = −0.30, p = 0.008; Pglo: r = −0.28, p = 0.025). In multiple regression analyses, Re and Pglo were significantly and negatively associated with SFcr after adjustment for other confounders. Conclusions: These findings suggest that tubular reabsorption of Cr can occur in some cases. Intrarenal glomerular hemodynamic burden may be related to tubular creatinine reabsorption, which possibly leads to lower Ccr values.

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Association of Albuminuria With Intraglomerular Hydrostatic Pressure and Insulin Resistance in Subjects With Impaired Fasting Glucose and/or Impaired Glucose Tolerance

Abstract: We demonstrated that increased insulin resistance is associated with increased P and UAE in IFG or IGT subjects. These hemodynamic burdens and insulin resistance may cause injury to the glomeruli even in subjects with IFG or IGT.

Cited by 32 publications

References 43 publications

Renal Biomarkers for Treatment Effect of Ranibizumab for Diabetic Macular Edema

Renal Biomarkers for Treatment Effect of Ranibizumab for Diabetic Macular Edema

Association of Noise Annoyance with Measured Renal Hemodynamic Changes

Increased Glomerular Hydrostatic Pressure is Associated with Tubular Creatinine Reabsorption in Healthy Subjects

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