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  • Type 1 (insulin-dependent) diabetes mellitus  (1)
  • Type 1 (insulin0dependent) diabetes mellitus  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Magnetic resonance imaging of the kidney in Type 1 (insulin-dependent) diabetes mellitus (1992)
    Springer
    Diabetologia 35 (1992), S. 1002-1008 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes mellitus ; diabetic nephropathy ; microalbuminuria ; magnetic resonance ; chronic renal failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Reductions in the physiological cortical to medullary signal intensity ratio are found in magnetic resonance scans of the kidney in non-diabetic glomerular disease. Whether this abnormality can also characterise patients with Type 1 (insulin-dependent) diabetes mellitus and nephropathy is not known. We measured the cortical to medullary signal intensity ratio in magnetic resonance images of the kidney in 34 patients with Type 1 diabetes (ten with either clinical proteinuria or raised serum creatinine or both, nine with microalbuminuria, seven with normal urinary albumin excretion and long duration of diabetes and eight with Type 1 diabetes of short duration). The cortical to medullary signal intensity ratio showed a trend to cluster at lower values in the normoalbuminuric patients with normal serum creatinine rather than in the nine healthy individuals, independent of Type 1 diabetes duration (1.47 ± 0.06 and 1.41 ± 0.13 vs 1.63 ± 0.16; five groups-Scheffé F-test p = 0.05–0.1). Among the Type 1 diabetic patients, significant reductions in the cortical to medullary signal intensity ratio characterised overt nephropathy (1.19 ± 0.15, p 〈0.05 vs all groups), but not microalbuminuria (1.47 ± 0.13, p = NS), concomitantly with low glomerular filtration rate and elevated fractional excretion of uric acid, but independent of glycaemic control. The determinants of the renal cortical to medullary signal intensity ratio in Type 1 diabetes are uncertain. Reductions in the cortical to medullary signal intensity ratio may be a late finding in diabetic nephropathy, and parallel the accompanying impairment in kidney haemodynamics. Magnetic resonance imaging of the kidney may not offer clues in the early diagnosis of diabetic nephropathy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00401433
    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
    Prevalence of hypertension and microalbuminuria in adult type 1 (insulin-dependent) diabetic patients without renal failure in Italy. I. Validation of screening techniques to detect microalbuminuria (1992)
    Springer
    Acta diabetologica 29 (1992), S. 156-166 
    Details
    ISSN: 1432-5233
    Keywords: Diabetic nephropathy ; Microalbuminuria ; Type 1 (insulin0dependent) diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The prevalence of microalbuminuria and arterial hypertension among type 1 (insulin-dependent) diabetic patients is poorly known in Italy. In the preliminary phase of a large outpatient screening programme, we addressed the possibility of using non-time urine samples to predit the chance of detecting albumin excretion rate (AER) in the range of microalbuminuria. We therefore measured urinary albumin and creatinine concentration in timed overnight collections from 641 type 1 diabetic patients with serum creatinine levels lower than 133 μmol/l. AER was strongly and comparably predicted both by urinary albumin concentration (UAlb;r 2=0.754) and by the urinary albumin to creatinine concentration ratio (A/C;r 2=0.773). After exploring several independent cut-off levels for UAlb and A/C, AER in the range 20–200 μg/min (n=91) was found to be predicted with 90% sensitivity and specificity either by UAlb≧20 mg/l or by A/C≧2.0 mg/mmol. UAlb was negatively associated with diuresis, and false negative outcomes were explained by polyuria when screening by this variable. A/C was positively associated with female gender among normoalbuminuric patients, in line with the lower urinary excretion of creatinine in women (7.2±0.25 vs 10.2±0.35 μmol/min,P〈0.00001). A significant excess of false positive outcomes in women compared with men was found when screening by any A/C cut-off level equal to or less than 2.5 mg/mmol. Simplified screening techniques seem to remain, however, a practicable option for the detection of microalbuminuria both in epidemiology and in clinical practice.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00573481
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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