ISSN:
1432-1440
Schlagwort(e):
Diabetes mellitus
;
Nephropathy
;
Serum beta2-microglobulin
Quelle:
Springer Online Journal Archives 1860-2000
Thema:
Medizin
Notizen:
Summary Detection of early diabetic nephropathy is necessary to postpone or even prevent progression of irreversible kidney damage by therapeutic measures. Beta2-microglobulin (β2-MG) as a parameter of the glomerular filtration rate has been measured by immunoassay in the serum of 100 diabetic subjects, 50 insulin-dependent (IDD), and 50 noninsulin-dependent (NIDD) patients. The results are compared with endogenous creatinine-clearance, serum creatinine concentration, and proteinuria and are related to different stages of diabetic retinopathy (RD). Normal values were obtained from 50 healthy age- and sex-matched subjects. A close correlation was found between β2-MG levels and endogenous creatinine clearance. Thirty-nine diabetics revealed an elevated β2-MG (2.5 mg/l or higher), only 16 of whom had increased serum creatinine levels (1.4 mg/dl or higher). Significant differences of β2-MG were obtained between each group of patients with different stages of RD. A relevant difference of serum creatinine was found only between patients with normal eye fundus and advanced proliferative retinopathy, respectively. Without RD 26% of the patients revealed elevated β2-MG but normal creatinine values demonstrating a “latent nephropathy”, just 8% showed an increase of both parameters. Of the diabetics with proliferative retinopathy 40% suffered from impaired kidney function proven by reduced creatinine clearance and by elevation of β2-MG and creatinine as well, 15% just revealed an increase of β2-MG with normal creatinine levels. The incidence and extent of nephropathy demonstrated by pathologic values of both β2-MG and serum creatinine were significantly higher in IDD patients with a smaller proportion of “latent nephropathy” as compared to NIDD patients (p〈0.02). This is also true for the markedly increased proteinuria in IDD subjects. In both groups, measurement of β2-MG disclosed more often decrease of renal function in diabetics than did concentrations of serum creatinine. The determination of serum β2-MG appears to be a reliable and sensitive method for the early detection of minor impairment of kidney function in diabetes mellitus.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1007/BF01537432
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