ISSN:
1432-0428
Keywords:
Type 1 (insulin-dependent) diabetes
;
urinary albumin excretion
;
exchangeable sodium
;
blood pressure
;
extracellular volume
;
plasma volume
;
catecholamines
;
renin
;
converting enzyme
;
angiotensin II
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary We studied 73 Type 1 (insulin-dependent) diabetic patients, 18 to 50 years of age, with a diabetes duration of more than five years. Group 1: normal urinary albumin excretion below 30 mg per 24 h (n=19); group 2: microalbuminuria, 30–300 mg per 24 h (n=36); and group 3: diabetic nephropathy, above 300 mg per 24 h (n=18). Fifteen non-diabetic persons matched for sex and age served as control subjects. The sodium intake evaluated on the basis of 24-h urine sodium excretion was similar in patients and control subjects. Blood pressure in groups 1 and 2 and control subjects was below 160/95 mmHg. The blood pressure was increased in group 3 as compared with the other groups (systolic/diastolic 161±22/101±9 mmHg vs 131±13/84±10, mean±SD, p〈0.0001). Exchangeable sodium was increased in patients (p〈0.01) and correlated to the mean blood pressure (n=70, r=0.41, p〈0.01). Extracellular volume was increased in patients (p〈0.05), whereas plasma volume was normal. Supine serum angiotensin II was suppressed in the patients (p〈0.001). A negative correlation was found between mean blood pressure and supine serum aldosterone (n=68, r=-0.24, p〈0.05), and exchangeable sodium and aldosterone (n=66, r=-0.36, p〈0.002) in all patients. The catecholamine levels were also suppressed or normal in the patients. These data suggest that sodium retention plays a major role and that the aldosterone, angiotensin II and catecholamine levels are suppressed during the blood pressure rise observed in the very early stages of diabetic renal disease.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00277316
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