ISSN:
1432-5233
Keywords:
Key words Angiotensin-converting enzyme (ACE) inhibition
;
Sodium retention
;
Renal dopamine
;
Atrial natriuretic peptide
;
Proximal tubule
;
Type 1 diabetes mellitus
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract The objective of the present study was to determine whether acute inhibition of angiotensin converting enzyme (ACE) normalizes intrarenal sodium handling, renal haemodynamics and renal dopamine output in response to an i.v. NaCl infusion in type 1 diabetic patients with early nephropathy. Nine diabetic patients (aged 28±3 years) with elevated urinary albumin excretion (173±39 mg ⋅ min–1) were studied. The effects of a 2-hour NaCl infusion (12.5 ml ⋅ kg–1⋅ h–1) on para-amino hippuric acid (PAH), inulin, lithium and sodium clearances as well as the urinary dopamine excretion were studied before and after 2 days of acute ACE inhibition. Fifteen healthy subjects (aged 34±1 years) served as controls. The results showed that 2 days of ACE inhibition improved the natriuretic response significantly (P〈0.05) within the first 2 h following an i.v. NaCl load due to a normalization of the proximal tubular sodium handling. In control subjects urinary dopamine output increased by 14% (P〈0.01) following i.v. NaCl infusion, whereas a blunted increase was seen in the diabetic patients, which tended to normalize following inhibition of ACE. In conclusion, this study demonstrates that patients with type 1 diabetes and early nephropathy display abnormalities in renal haemodynamics, natriuresis and urinary dopamine mobilization in response to a sodium load, which can be reversed by short-term inhibition of ACE.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s005920050058
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