Increased kidney size, glomerular filtration rate and renal plasma flow in short-term insulin-dependent diabetics

Abstract

Summary. Glomerular filtration rate (GFR), renal plasma flow (RPF) and kidney volume were measured in thirteen male subjects (mean age 30 years) with short-term insulin-dependent diabetes (mean duration of disease 2.4 years) and fourteen normal male subjects (mean age 29 years). GFR and RPF were measured by constant infusion technique using I125-iothalamate and 13q-hippuran. Kidney size was determined by means of ultrasound. GFR, RPF and kidney volume were increased in the diabetic patients compared to the normal controls, 144 versus 113 ml/ min • 1.73 m 2 (p < 0.0005), 627 versus 523 ml/ min x 1.73 m 2 (p < 0.0025) and 278 versus 224 ml/ 1.73 m 2 (p < 0.0005) respectively. Combining results from diabetic patients and controls revealed a positive correlation between kidney size and GFR (r = 0.70, p < 0.001) and between kidney size and RPF (r = 0.61, p < 0.001). Within the groups kidney size and RPF correlated significantly in the diabetics (p < 0.01) and the same was found for kidney size and GFR (0.025< p < 0.05), while no correlations were found in the normal group. GFR and RPF correlated in the diabetics when evaluated separately (r = 0.81, p < 0.001) and in the controls (r = 0.73, p < 0.001). The previous and present data suggest that the mechanisms of the elevated GFR in insulin-dependent diabetics are enhanced RPF, increased transglomerular hydrostatic pressure gradient and increased glomerular ultrafiltration coefficient. The increased kidney size is probably the main cause of the above alterations in the GFR determinants.

Determinants and Functional Significance of Renal Parenchymal Volume in Adults

“…Correlations between size and function have been found in adults with hypertension or renal disease using urography (46), in diabetics (1,38) and elderly hospitalized patients (47) using sonography, and in disease-free cancer patients using CT scanning (23). However, no correlation was found between sonographic kidney size and GFR in normal subjects (38). Our data show that there is a strong relationship between renal parenchymal volume and GFR and that this correlation remained highly significant when age, gender, race, and body size were taken into account.…”

Effect of Bitter Gourd (Momordica charantia) on Glycaemic Status in Streptozotocin Induced Diabetic Rats

“…Hyperfunctional kidney with increase in GFR is reported in the early stages of diabetes [19]. Long term metabolic control is known to reduce kidney filtration in human diabetic subjects [20].…”

Sorbinil does not prevent hyperfiltration, elevated ultrafiltration pressure and albuminuria in streptozotocin-diabetic rats

“…Albumin excretion was increased to the same extent in the sorbinil-treated and in the untreated diabetic rats. We conclude that increased metabolism of glucose to sorbitol does not cause the hyperfiltration in rats with streptozotocin-induced diabetes.Key words: Streptozotocin diabetic rat, aldose reductase inhibition, glomerular filtration rate, ultrafiltration pressure, albuminuria.Glomerular hyperfiltration, intrarenal hypertension and kidney enlargement are typical findings in the early stage of human Type 1 (insulin-dependent) diabetes mellitus as well as in experimental diabetes [1][2][3][4]. It has been shown that in experimental diabetes, elevations in single nephron glomerular filtration rate (SNGFR) result from concomitant elevations in ultrafiltration pressure and glomerular plasma flow [5].…”

“…Glomerular hyperfiltration, intrarenal hypertension and kidney enlargement are typical findings in the early stage of human Type 1 (insulin-dependent) diabetes mellitus as well as in experimental diabetes [1][2][3][4]. It has been shown that in experimental diabetes, elevations in single nephron glomerular filtration rate (SNGFR) result from concomitant elevations in ultrafiltration pressure and glomerular plasma flow [5].…”