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  • Articles: DFG German National Licenses  (2)
  • Type 1 (insulin-dependent) diabetes  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Reduction of protein intake decreases glomerular filtration rate in young Type 1 (insulin-dependent) diabetic patients mainly in hyperfiltering patients (1988)
    Springer
    Diabetologia 31 (1988), S. 878-883 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes ; renal hyperfiltration ; microalbuminuria ; protein restriction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The influence of different protein intake on renal function was studied in 16 Type 1 (insulin-dependent) diabetic patients, aged 15–23 years, with onset of diabetes before puberty and with a duration of diabetes between 5 and 20 years. The glomerular filtration rate, renal plasma flow, albumin excretion rate, and blood pressure were examined in a cross-over randomised order after 10 days on isocaloric diets with either 10% (i.e. 0.9±0.06 g·kg−1·day−1) or 20% (1.9±0.1 g·kg−1·day−1) of the calories as protein, the latter being equal to the recommended diet. Dietary compliance was evaluated using fractional phosphate excretion and overnight urea excretion. Glomerular filtration rate was lower after the low-protein diet compared to the usual protein diet (p〈0.001). Patients with glomerular filtration rate above +2 SD of the normal mean on the usual protein diet (n=6) exhibited the steepest fall in glomerular filtration rate with a mean decrease of 20ml/min compared to 7 ml/min in those with initially normal glomerular filtration (p=0.01). Filtration fraction tended to decrease on low protein diet, more so in initially hyperfiltering patients (p=0.09). Renal plasma flow remained unchanged. In patients with elevated glomerular filtration rate on usual protein diet, albumin excretion rate and systolic, but not diastolic blood pressure, were decreased on low protein diet (p=0.03 and p=0.01, respectively) but not in initially normal-filtering patients. Mean blood glucose and serum fructosamine were unchanged on both diets. In conclusion, low protein diet decreases glomerular filtration rate independently of glycaemic control in young Type 1 diabetic patients and more so in hyperfiltering patients. This decline in glomerular filtration rate is accompanied by a decrease in albumin excretion rate and systolic blood pressure in hyper-filtering patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00265370
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Enalapril reduces microalbuminuria in young normotensive Type 1 (insulin-dependent) diabetic patients irrespective of its hypotensive effect (1990)
    Springer
    Diabetologia 33 (1990), S. 470-476 
    Details
    ISSN: 1432-0428
    Keywords: Albumin excretion rate ; angiotensin converting enzyme inhibitor ; blood pressure ; Type 1 (insulin-dependent) diabetes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of enalapril on albumin excretion rate was studied in two groups of age- and sex-matched Type 1 (insulin-dependent) diabetic patients, aged 15–20 years, with persistent microalbuminuria 〉20 μg/min. Group 1 contained six patients with systolic blood pressure ≥ 75th percentile for age and sex, group 2 six normotensive patients. Enalapril (10–20 mg/day) was given for six months. Albumin excretion rate, glomerular filtration rate, renal plasma flow, blood pressure at rest and during exercise, and angiotensin converting enzyme activity were measured before, after three weeks' and six months' treatment and six months after treatment withdrawal. Albumin excretion rate decreased in all patients after three weeks' (mean decreases 55% in group 1, 65% in group 2) and six months' treatment (35% in group 1, 61% in group 2). Systolic blood pressure remained unchanged in both groups. Diastolic pressure was reduced after three weeks in group 1 (p=0.001). No reduction in increment in systolic pressure during exercise test occurred in any group during treatment. Angiotensin converting enzyme activity decreased in all patients after three weeks (p=0.001) and six months (p=0.003). This correlated to the decrease in albumin excretion rate after three weeks (r=0.79, p=0.05) and six months (r=0.59, p=0.04). HbA1c, mean blood glucose and glomerular filtration rate remained unchanged during the study in both groups. Renal plasma flow tended to increase after three weeks' and six months' treatment in group 2 (p=0.06, respectively) but not in group 1. Filtration fraction decreased after three weeks (p=0.04) only in group 2. In conclusion, enalapril reduces the albumin excretion rate in adolescent diabetic patients with or without elevated blood pressure. This reduction was not accompanied by a decreased systemic pressure but rather by a fall in filtration fraction in normotensive patients, indicating a direct effect, irrespective of the antihypertensive, on intraglomerular pressure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00405108
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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