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  • 1
    Electronic Resource
    Electronic Resource
    Kidney function and size in type 1 (insulin-dependent) diabetic patients before and during growth hormone administration for one week (1982)
    Springer
    Diabetologia 22 (1982), S. 333-337 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 diabetes ; glomerular filtration rate ; renal plasma flow ; kidney size ; growth hormone ; albumin ; β-2-microglobulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Kidney function and size were studied in seven well-controlled male Type 1 (insulin-dependent) diabetic patients before and after administration of highly purified human growth hormone for one week. Glomerular filtration rate, renal plasma flow (steady state infusion technique with urinary collections using 125I-iothalamate and 131I-hippuran), kidney size (ultrasonic scanning) and urinary excretion rates of albumin and β-2-microglobulin were measured. Highly purified growth hormone was injected subcutaneously, 2 IU in the morning and 4 IU in the evening. The growth hormone dosage applied induced an elevation in plasma growth hormone concentration from the normal level seen in these very well controlled diabetics to levels within the range previously demonstrated in normally controlled Type 1 diabetic patients. During the week of growth hormone administration, glycaemic control was maintained unchanged by increasing the insulin dose by 79 ±9% (mean ± SEM). Glomerular filtration rate increased from 122±3 to 131±3 ml/min × 1.73 m2 (p 〈0.05) and renal plasma flow increased from 535±10 to 569±22 ml/min × 1.73 m2 (p〈0.05). Kidney size changed from 128±5 to 133±5 ml/1.73 m2 (NS). Urinary excretion rates of albumin and β-2-microglobulin were unchanged. The present findings suggest that the growth hormone elevation typically found in Type 1 diabetic patients with reasonable clinical control, contributes to the enhanced glomerular filtration rate and renal plasma flow present in that disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00253577
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  • 2
    Electronic Resource
    Electronic Resource
    The effect of glucagon infusion on kidney function in short-term insulin-dependent juvenile diabetics (1980)
    Springer
    Diabetologia 19 (1980), S. 350-354 
    Details
    ISSN: 1432-0428
    Keywords: Albumin ; β 2-microglobulin ; glomerularfiltration rate ; glucagon ; insulin-dependent diabetes kidney function ; renal plasma flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Kidney function was studied in nine, metabolically well controlled, short-term insulin-dependent male diabetics before and during glucagon infusion of 4 to 5 and 8 to 10 ng/kg/min. Glomerular filtration rate, effective renal plasma flow (steadystate infusion technique, with urinary collections, using 125I-iothalamate and 131I-iodohippurate), and urinary albumin and β 2-microglobulin excretion rates were measured. The mean plasma glucagon concentration increased during infusion from 254±19 pg/ ml to 440±31 pg/ml (low dose) and 730±52 pg/ml (high dose). Glomerular filtration rate increased in all subjects from 133±5 before the glucagon infusion to 141±4 with the low dose, and 148±7 ml/min/1.73 m2 with the high dose (p〈0.01). The increase in glomerular filtration rate correlated with the rise in plasma glucagon concentration (r=0.67; p〈0.01). Renal plasma flow increased from 530 ±21 before the glucagon infusion to 555±20 with the low dose and 572±29 ml/min/1.73 m2 with the high dose (p〈0.01). Urinary β 2-microglobulin excretion rate rose from 5.8±1.0 before infusion to 8.7±1.7 with the low dose, and 17.9±5.7 μg X 10-2/min with the high dose (p〈0.01). Urinary albumin excretion remained unchanged during the glucagon infusion. These results suggest that glucagon may contribute to the reversible elevation of glomerular filtration rate typically found in poorly regulated insulin-dependent diabetics, but not to the moderate elevation found in well controlled diabetics.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00280519
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  • 3
    Electronic Resource
    Electronic Resource
    Prevalence of micro- and macroalbuminuria, arterial hypertension, retinopathy and large vessel disease in European Type 2 (non-insulin-dependent) diabetic patients (1991)
    Springer
    Diabetologia 34 (1991), S. 655-661 
    Details
    ISSN: 1432-0428
    Keywords: Type 2 (non-insulin-dependent) diabetes mellitus ; microalbuminuria ; macroalbuminuria ; arterial hypertension ; retinopathy ; macroangiopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The prevalence of micro- and macroalbuminuria was determined in Type 2 (non-insulin-dependent) diabetic patients, less than 76 years of age, attending a diabetic clinic during 1987. All eligible patients (n=557) were asked to collect a 24-h urine sample for quantitative albumin analysis. Urine collections were obtained in 296 males and 253 females (96%). Normoalbuminuria were defined as urinary albumin excretion≤30 mg/24 h (n=323), microalbuminuria as 31–299 mg/24 h (n=151), and macroalbuminuria as ≥300 mg/ 24 h (n=75). The prevalence of macroalbuminuria was significantly higher in males (20%) than in females (6%), while the prevalence of microalbuminuria was almost identical in males (26%) and females (29%). The prevalence of arterial hypertension increased with increased albuminuria, being 48%, 68%, and 85% in patients with normoalbuminuria, microalbuminuria, and macroalbuminuria respectively. Prevalence of proliferative retinopathy rose with increasing albuminuria, being 2%, 5% and 12% in patients with normoalbuminuria, microalbuminuria, and macroalbuminuria respectively. Prevalence of coronary heart disease, based on Minnesota coded electrocardiograms, was more frequent in patients with macroalbuminuria (46%) compared to patients with microalbuminuria (26%) and patients with normoalbuminuria (22%). Foot ulcers were more frequent in micro- and macroalbuminuric patients, being 13% and 25%, respectively, compared to 5% in patients with normoalbuminuria. This cross-sectional study has revealed a high prevalence of microalbuminuria (27%) and macroalbuminuria (14%) in Type 2 diabetic patients. Patients with raised urinary albumin excretion are characterized by obesity, elevated haemoglobin Alc, increased frequency of arterial hypertension, proliferative retinopathy, coronary heart disease and foot ulcers. Thus, these findings suggest that urinary excretion of albumin should be monitored routinely in patients with Type 2 diabetes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400995
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  • 4
    Electronic Resource
    Electronic Resource
    Renoprotection in diabetes: genetic and non-genetic risk factors and treatment (1998)
    Springer
    Diabetologia 41 (1998), S. 745-759 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Type I and Type II diabetes ; microalbuminuria ; diabetic nephropathy ; antihypertensive treatment ; angiotensin converting inhibition ; renal progression promoters ; insertion/deletion polymorphism of angiotensin converting enzyme gene ; end stage renal failure ; glycaemic control.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050983
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  • 5
    Electronic Resource
    Electronic Resource
    The effect of intravenous insulin infusion on kidney function in insulin-dependent diabetes mellitus (1981)
    Springer
    Diabetologia 20 (1981), S. 199-204 
    Details
    ISSN: 1432-0428
    Keywords: Insulin-dependent diabetes ; glomerular filtration rate ; renal plasma flow ; insulin infusion ; hyperglycaemia ; β-2-microglobulin ; albumin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Glomerular filtration rate, renal plasma flow, urinary excretion of β-2-microglobulin and albumin, heart rate and blood pressure were studied in eight young male insulin-dependent diabetics. Measurements were performed before and during insulin infusion at 2 mU/kg/min. No patient had discernible insulin antibodies. Two studies were performed at random in each patient. In series A blood glucose concentration was allowed to decline, while in series B it was maintained at a constant level. Ten 20 min clearance periods were performed, four before and six during insulin infusion. Results are given as mean±SEM of values from the first four (control) and last four (test) clearance periods. Blood glucose declined in series A experiments from 10.8±0.8 mmol/l in the control period to 5.8±0.5 mmol/l during the test period, but remained constant during experiment B (9.8±1.1 and 9.5±1.1 mmol/l). Plasma insulin levels were comparable in the two series. Glomerular filtration rate fell from 141±7 ml/ min X 1.73m2 to 132±7ml/min X 1.73m2 (p〈 0.01) in series A but did not change significantly during series B. Similarily renal plasma flow declined with declining glucose but remained constant when glucose was maintained at a constant level. In series A the magnitude of decrease in renal plasma flow was correlated with the magnitude of decrease in glomerular filtration rate (r=0.95, p〈 0.001). β-2-microglobulin excretion decreased significantly (p 〈 0.05) in both series (A: 89±17 to 60±13 ng/min, B: 117±46 to 62±17ng/min). Albumin excretion increased in five out of six patients with normal control values (not significant) in series A and in four out of six in series B. No significant changes in heart rate or blood pressure were observed. Thus insulin infusion reduced renal plasma flow and glomerular filtration rate, but this effect could be completely abolished by keeping blood glucose constant. This suggests that it is not the lack of insulin but the associated hyperglycaemia which contributes to the elevated renal plasma flow and glomerular filtration rate in insulin-dependent diabetics.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00252628
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  • 6
    Electronic Resource
    Electronic Resource
    Increased kidney size, glomerular filtration rate and renal plasma flow in short-term insulin-dependent diabetics (1981)
    Springer
    Diabetologia 20 (1981), S. 451-456 
    Details
    ISSN: 1432-0428
    Keywords: Glomerular filtration rate ; renal plasma flow ; kidney size ; insulin-dependent diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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 131I-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×1.73m2 (p〈0.0005), 627 versus 523 ml/ min×1.73 m2 (p〈0.0025) and 278 versus 224 ml/ 1.73 m2 (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.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00253406
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  • 7
    Electronic Resource
    Electronic Resource
    Effect of intravenous glucose infusion on renal function in normal man and in insulin-dependent diabetics (1981)
    Springer
    Diabetologia 21 (1981), S. 368-373 
    Details
    ISSN: 1432-0428
    Keywords: Insulin-dependent diabetes ; blood glucose concentration ; glomerular filtration rate ; renal plasma flow ; albumin, β-2-microglobulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of intravenous glucose infusion on glomerular filtration rate and renal plasma flow (constant infusion technique using 125I-iothalamate and 131I-hippuran) and on urinary excretion of albumin and β-2-microglobulin were studied in ten normal subjects and seven metabolically well-controlled insulin-dependent diabetics. Following glucose infusion in normal subjects (n = 10) blood glucose increased from 4.7±0.1 to 10.9±0.4 mmol/1 (SEM) (p ⩽ 0.01). Glomerular filtration rate increased from 116±2 to 123±3ml/min x 1.73 m2 (p ⩽ 0,01), while no change in renal plasma flow was seen 552±11 versus 553±18 ml/min × 1.73 m2. Volume expansion with intravenous saline infusion in six of the normal subjects induced no changes in blood glucose or kidney function. In seven strictly controlled insulin-dependent diabetics, blood glucose values were raised from 4.6±0.4 to 16.0±0.6 mmol/1 and clamped by means of an ‘artificial beta cell’. Glomerular filtration rate increased in all patients, from 133 ±5 to 140±6 ml/min × 1.73 m2 (p ⩽ 0.02), as did renal plasma flow from 576±26 to 623±38 ml/ min × 1.73 m2 (p ⩽ 0.02). Urinary albumin excretion remained unchanged in both normal subjects and diabetics. β-2-microglobulin excretion rate increased significantly in the diabetics following glucose infusion, while no significant change was seen in the normal subjects. Our results show that hyperglycaemia per se contributes to the increased glomerular filtration rate and renal plasma flow in insulin-dependent diabetes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00252683
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  • 8
    Electronic Resource
    Electronic Resource
    Renal function in streptozotocin-diabetic rats (1981)
    Springer
    Diabetologia 21 (1981), S. 409-414 
    Details
    ISSN: 1432-0428
    Keywords: Streptozotocin ; diabetes ; rat ; micropuncture ; renal plasma flow ; glomerular filtration ; hydraulic pressure ; ultrafiltration coefficient
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Renal function was examined with micropuncture methods in the insulin-treated streptozotocin-diabetic rat. Kidney glomerular filtration rate was significantly higher in the diabetic rats (1.21 ml/min) than in the control group (0.84 ml/min) Nephron glomerular filtration rate increased in proportion to the rise in kidney glomerular filtration rate (diabetic rats: 37.0 nl/min; control rats: 27.9 nl/min). Likewise renal plasma flow was significantly higher in the diabetic rats (4.1 ml/min) than in the control group (3.0 ml/min). Glomerular capillary pressure was identical in both groups (56.0 and 56.0 mmHg, respectively). The proximal intratubular pressure was significantly reduced in the diabetic rats (10.4 mmHg; control value: 12.5 mmHg). The effective glomerular ultrafiltration coefficient was slightly but not significantly higher in the diabetic rats (0.027 nl s-1mmHg-1) than in the control group (0.023 nl s-1mmHg-1). Kidney weight was significantly higher in the diabetic rats (1.15 g; control rats: 0.96 g) while body weight was similar in both groups (diabetic rats: 232 g; control rats: 238 g). Calculations indicate that the increases in transglomerular hydraulic pressure, renal plasma flow and ultrafiltration co-efficient of the glomerular membrane contribute about equally to the rise in glomerular filtration rate. The increases in the values of the determinants of glomerular filtration rate may be the result of renal hypertrophy. These studies suggest that this model provides a useful method for investigating kidney function in diabetes, which may have relevance for our understanding of the kidney abnormalities in human diabetes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00252690
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  • 9
    Electronic Resource
    Electronic Resource
    Glomerular hyperfiltration in microalbuminuric NIDDM patients (1996)
    Springer
    Diabetologia 39 (1996), S. 1584-1589 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Glomerular hyperfiltration rate ; microalbuminuria ; hyperfiltration ; NIDDM.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Glomerular hyperfiltration and microalbuminuria are both regarded as risk factors for the development of diabetic nephropathy in insulin-dependent diabetic patients. Information on glomerular hyperfiltration is scarse in microalbuminuric non-insulin-dependent diabetic (NIDDM) patients. Therefore, we performed a cross-sectional study of glomerular filtration rate (single i. v. bolus injection of 51Cr-EDTA, plasma clearance for 4 h) in 158 microalbuminuric NIDDM patients compared to 39 normoalbuminuric NIDDM patients and 20 non-diabetic control subjects. The groups were well-matched with regard to sex, age and body mass index. The uncorrected (ml/min) and the adjusted (ml · min–1· 1.73 m–2) glomerular filtration rate were both clearly elevated in the microalbuminuric patients: 139 ± 29 and 117 ± 24 as compared to 115 ± 19 and 99 ± 15; 111 ± 23 and 98 ± 21 in normoalbuminuric NIDDM patients and control subjects, respectively (p 〈 0.001). The glomerular filtration rate (ml · min–1· 1.73 m–2) in NIDDM patients who had never received antihypertensive treatment was also clearly elevated in the microalbuminuric patients (n = 96): 119 ± 22 as compared to 100 ± 14 and 98 ± 21 in normoalbuminuric NIDDM patients (n = 27) and control subjects (n = 20), respectively (p 〈 0.001). Glomerular hyperfiltration (elevation above mean glomerular filtration rate plus 2 SD in normoalbuminuric NIDDM patients) was demonstrated in 37 (95 % confidence interval 30–45)% of the microalbuminuric patients. Multiple regression analysis revealed that HbA1 c, 24-h urinary sodium excretion, age and known duration of diabetes were correlated with glomerular filtration rate in microalbuminuric NIDDM patients (r 2 = 0.21, p 〈 0.01). Our cross-sectional study indicates that NIDDM patients at high risk of developing diabetic nephropathy are also characterized by an additional putative risk factor for progression, glomerular hyperfiltration. [Diabetologia (1996) 39: 1584–1589]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050618
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