Monitoring Diabetic Nephropathy: Glomerular Filtration Rate and Abnormal Albuminuria in Diabetic Renal Disease—Reproducibility, Progression, and Efficacy of Antihypertensive Intervention

Mogensen, Carl Erik; Hansen, Klavs Würgler; Nielsén, Sören; Pedersen, Margrethe Mau; Rehling, Michael; Schmitz, A.

doi:10.1016/s0272-6386(12)70184-1

Cited by 58 publications

(27 citation statements)

References 33 publications

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“…Several studies have associated an increased albumin excretion rate in type 2 DM patients with various potentially reversible risk factors including systolic blood pressure [4], smoking, dyslipidemia [5], obesity, and glycemic control [6]. Microalbuminuria may be an almost ideal parameter to assess early renal dysfunction in DM during therapeutic intervention, because glomerular filtration rate (GFR) is well preserved and often increased in these patients in each nephropathy in both type 1 and type 2 DM [7, 8, 9]. …”

Section: Introductionmentioning

confidence: 99%

Relationship between Urinary Albumin Excretion and Glomerular Filtration Rate in Normotensive, Nonproteinuric Patients with Type 2 Diabetes mellitus

Taniwaki

Ishimura²,

Emoto³

et al. 2000

Nephron

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Background/Aim: In patients with type 2 diabetes mellitus, the relationship between glomerular filtration rate (GFR) and urinary albumin excretion remains an unresolved issue. In order to investigate the early renal function abnormalities, GFR and urinary albumin excretion were assessed, and their relationship was examined in normotensive patients with type 2 diabetes mellitus. Methods: In a cross-sectional study of 85 nonhypertensive Japanese patients with type 2 diabetes mellitus not showing overt proteinuria, the GFR was measured using ^99mTc-diethylenetriamine pentaacetate renography. Fifty-one diabetic patients lacked microalbuminuria (albumin excretion <30 mg/day), while 34 patients showed microalbuminuria (between 30 and 300 mg/day). Fifteen healthy subjects served as controls. Results: The three groups were well matched with regard to gender, age, and body mass index. The GFR in microalbuminuric patients (134 ± 23 ml/min/1.48 m²) was significantly higher than in patients without microalbuminuria (108 ± 21 ml/min/1.48 m²) and in controls (109 ± 18 ml/min/1.48 m²; p < 0.0001). In type 2 diabetic patients, the GFR positively correlated with the logarithmically transformed urinary albumin excretion. Multiple regression analysis showed that the urinary albumin excretion was significantly and independently affected by GFR (β = 0.548), duration of diabetes (β = 0.297), and systolic blood pressure (β = 0.232; R² = 0.409; p < 0.0001). Conclusion: It is suggested that one of the mechanisms underlying increased urinary albumin excretion in early nephropathy in normotensive type 2 diabetes is glomerular hyperfiltration.

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Section: Introductionmentioning

confidence: 99%

Relationship between Urinary Albumin Excretion and Glomerular Filtration Rate in Normotensive, Nonproteinuric Patients with Type 2 Diabetes mellitus

Taniwaki

Ishimura²,

Emoto³

et al. 2000

Nephron

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“…H, the renal threshold, was taken as 10 mmol [29], whereas F G , the glomerular filtration rate, calculated from the Cockcroft-Gault equation [30] F G = (140 − age) · weight 1200 , dm 3 . h −1 in which we have taken a representative value of 10 mg · dm −3 for the concentration of plasma creatinine.…”

Section: Two-compartment Minimal Model Of Plasma Glucose Metabolismmentioning

confidence: 99%

Glycogenesis and glucose oxidation during an intravenous glucose tolerance test in man

et al. 2004

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The quantity of deuterated glucose customarily given in labelled IVGTTs (intravenous glucose tolerance tests) changes the isotopic composition of the subject's body water enough to be detected by mass spectrometric techniques. Glucose undergoing direct glycogenesis does not contribute label to the body water pool, and isotope incorporated into it must have come from glucose that has either been oxidized or undergone indirect glycogenesis. By subtracting the amount of label found in body water from the total amount of glucose utilized, as calculated from the minimal model of glucose disappearance, it should be possible to study the partitioning of the dose given between direct glycogenesis in skeletal muscle and other metabolic pathways. To establish these principles, we used isotope ratio MS to determine body water composition in groups of healthy ( n =7; mean weight, 76 kg; fasting plasma glucose and insulin, 5.1 mmol and 40 pmol respectively) and Type II diabetic ( n =5; mean weight, 84 kg; fasting plasma glucose and insulin, 6.2 mmol and 75 pmol respectively) subjects undergoing IVGTTs. It was found that, for healthy subjects, 31% of the dose given was utilized in direct glycogenesis and this was decreased to 15% in diabetes. Defects in muscle glycogen synthesis in diabetes of the same order are well known from magnetic resonance studies. We conclude that measurement of label incorporation into body water is potentially useful for investigation of the metabolism of a glucose load in vivo during an IVGTT.

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“…Nachdem eine manifeste diabetische Nephropathie entstanden ist, kommt es ohne spezifische Intervention zu einem langsamen Abfall der glomerulären Filtrationsrate ( GFR) über mehrere Jahre,der individuell erheblich schwanken kann (Abnahme ca.2-20 ml/min/Jahr). Eine Progression zur terminalen Niereninsuffizienz entwickeln innerhalb von 10 Jahren 50% der Typ-1-Diabetiker mit manifester diabetischer Nephropathie und innerhalb von 20 Jahren >75% [3].…”

Section: Epidemiologieunclassified

Diagnostik und Therapie der diabetischen Nephropathie

2003

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Monitoring Diabetic Nephropathy: Glomerular Filtration Rate and Abnormal Albuminuria in Diabetic Renal Disease—Reproducibility, Progression, and Efficacy of Antihypertensive Intervention

Cited by 58 publications

References 33 publications

Relationship between Urinary Albumin Excretion and Glomerular Filtration Rate in Normotensive, Nonproteinuric Patients with Type 2 Diabetes mellitus

Relationship between Urinary Albumin Excretion and Glomerular Filtration Rate in Normotensive, Nonproteinuric Patients with Type 2 Diabetes mellitus

Glycogenesis and glucose oxidation during an intravenous glucose tolerance test in man

Diagnostik und Therapie der diabetischen Nephropathie

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