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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recurrence of diabetic nephropathy in the allograft of diabetics with end-stage renal disease who undergo renal transplantation has been reported. We report a case of a patient who underwent cadaveric renal transplantation for end-stage renal disease secondary to chronic glomerulonephritis 13 years ago. He developed steroid-induced, insulin-dependent diabetes mellitus 9 months after transplantation and florid nephrotic syndrome with progressive functional impairment due to biopsy-proven diabetic nephropathy 11 years later. This is, to our knowledge, the first report of de novo diabetic nephropathy in a renal allograft of a patient who was not a diabetic at the time of transplantation. It is suggested that histopathologic changes of diabetes mellitus cannot only recur in a renal allograft, but also can develop de novo and lead to functional impairment and ultimately affect graft survival. In view of increasing patient and graft survival in transplanted diabetic and non-diabetic patients, it is reasonable to anticipate an increased incidence of this complication.
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PMID:De novo diabetic nephropathy with functional impairment in a renal allograft. 354 53

This report is an attempt to gain more complete knowledge of the causes of the tendency to thrombosis in the nephrotic syndrome. Our purpose was to detect some rheological abnormalities in a group of nephrotic patients having normal renal function. Plasma and blood viscosity, erythrocyte filtration flow (EFF) and some indices of the carbohydrate metabolic state (glycosylated hemoglobin A1c; HbA1c, fasting glycemia and oral glucose tolerance test) were investigated in 10 patients with newly diagnosed primary nephrotic syndrome and 10 healthy subjects. EFF was determined in order to avoid variables depending upon plasma, white cells and hematocrit. The mean level of HbA1c was higher in the nephrotic group, in which we found 4 patients with impaired glucose tolerance according to the criteria of the National Diabetes Data Group. EFF was lower in nephrotic patients than in controls and correlated inversely with HbA1c. These findings indicate that nephrotic patients have a reduced red cell deformability which seems to be related to the abnormal carbohydrate metabolism commonly observed in this syndrome.
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PMID:Rheological abnormalities of erythrocyte deformability and increased glycosylation of hemoglobin in the nephrotic syndrome. 357 69

A child developed steroid-responsive nephrotic syndrome at the age of 3 years. 6 years later, he developed insulin-dependent diabetes mellitus. At this time renal biopsy disclosed minimal-change disease. After multiple relapses requiring cyclophosphamide or repeated courses of steroid therapy, a second renal biopsy, 5 years after the first, revealed early diabetic changes with associated exudative lesions. The nephrotic syndrome remains responsive to steroids and cyclophosphamide, and the patient maintains an increased glomerular filtration rate and normal blood pressure 3.5 years afterwards. His HLA typing showed DR4 and DR7. Since DR4 and DR7 are associated with diabetes and minimal-change disease, respectively, we speculate that he could carry the genetic predisposition for the development of both diseases.
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PMID:Steroid-responsive relapsing nephrotic syndrome associated with early diabetic glomerulopathy in a child. 360 Sep 16

Altered mental status, acanthosis nigricans, immune complex glomerulonephritis with nephrotic syndrome, fasting hypoglycemia, and postprandial hyperglycemia associated with anti-insulin receptor antibodies (type B insulin resistance) developed in a 43-year-old black woman who initially was treated for diabetes mellitus. Her HLA phenotype was A2, A29, Bw45(w6), B13(w4), Cw3, DR1 (DQw1). Her serum contained immune complexes, low complement levels, and antibodies that bound to the glomerular mesangium of mouse kidney. All clinical and serologic abnormalities resolved with combination cyclophosphamide and glucocorticoid treatment, and low doses of these agents have maintained the remission for more than a year.
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PMID:Successful immunosuppressive therapy in a patient with autoantibodies to insulin receptors and immune complex glomerulonephritis. 360 12

We evaluated changes in dialysate losses of protein and absorption of glucose, serum chemistries including protein electrophoresis, and serum lipids among patients who had undergone continuous ambulatory peritoneal dialysis (CAPD) for at least 1 year. The patients' race, sex, and the presence of diabetes mellitus did not influence the results. Over a 2-year period, daily protein losses and glucose absorption from dialysate were constant, serum protein electrophoresis did not show changes consistent with the nephrotic syndrome, serum cholesterol increased after 1 year of therapy but stabilized thereafter, and concentrations of high density lipoproteins did not decrease.
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PMID:Diabetes, dialysate losses, and serum lipids during continuous ambulatory peritoneal dialysis. 360 88

A prospective four-year study on the infection rate of clean operative wounds is presented. From January 1982 to June 1985, a nurse epidemiologist and a medical team assessed 4,468 operative procedures, from the day of surgery to the patients' discharge from the hospital. The infection rate was 3.2%. A higher incidence of wound infection was detected in patients requiring emergency operations (5.1%), in drained wounds (5.4%), and in patients with conditions thought to predispose to infection, such as advanced cancer, hepatic cirrhosis, diabetes, nephrotic syndrome, previous splenectomy, and treatment with immunosuppressive drugs (7.8%). Age over 65 did not influence infection rates. There were up to tenfold differences in infection indices between surgeons performing the same clean procedures. The continued monitoring of clean wound infection rates allowed the early detection and control of infection outbreaks. Providing periodic information on infection rates to the different surgical services was associated with decreasing infection rates over time.
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PMID:Surgical wound infections: prospective study of 4,468 clean wounds. 365 Feb 4

Renal biopsies were obtained from 164 patients with diabetes mellitus. Their histological changes were evaluated together with clinical findings and prognosis. In 36 patients, various types of glomerulonephritis were complicated: mesangial proliferative glomerulonephritis (17 patients), membranous glomerulonephritis (8), endocapillary proliferative glomerulonephritis (5), membranoproliferative glomerulonephritis (4) and minimal change nephrotic syndrome (2). Superimposed glomerulonephritis was suspected in diabetic patients with a short history of less than 5 years, persistent proteinuria, occasional hematuria and no retinopathy. They may, however, produce little effects on the long-term prognosis of diabetic patients except membranoproliferative glomerulonephritis.
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PMID:Glomerulonephritis in diabetic patients and its effect on the prognosis. 370 65

Acetylcholine (ACh) is localized in the syncytiotrophoblast layer of the human placental villous tissue. An attempt was made to correlate the ACh synthesis in different pathological placentas with the histopathology of the syncytiotrophoblast available in the literature. The ACh synthesis was estimated by 'in vitro' incubation of the placental tissue. Full-term (36-38 weeks) vaginally delivered pathological placentas and hydatid moles (28 weeks) were compared with normal placentas of the same age. The results suggested that: ACh synthesis is normal in states with normal syncytiotrophoblast (e.g., healthy greater than 42 week placenta, placenta praevia, twins, and hydramnios); high ACh synthesis is correlated with hormonal and immunological changes (e.g., diabetes mellitus and Rh-incompatibility); low levels of ACh synthesis occur in states with moderate syncytial degeneration (e.g., nephrotic syndrome and essential hypertension); very poor ACh synthesis occurs when syncytial degeneration is advanced (e.g., preeclampsia, eclampsia, intra-uterine death of fetus, vesicles of hydatid mole and placental tissue infarcts); and ACh synthesis is nil in material that is completely devoid of syncytiotrophoblast (e.g., placental tissue-like material, which rarely appears in between the vesicles of hydatid moles). In essence, the degree of reduction in ACh synthesis seems to correlate with the state of the syncytiotrophoblast in various pathological conditions; and ACh synthesis is greatly reduced during syncytial degeneration. It is concluded that the capacity of the placenta to synthesize ACh reflects the state of the syncytiotrophoblast.
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PMID:A correlative review of acetylcholine synthesis in relation to histopathology of the human syncytiotrophoblast. 379 52

A 61-yr-old man presented with the nephrotic syndrome and normal oral glucose tolerance. Renal biopsy showed the nodular (Kimmelstiel-Wilson) and diffuse glomerulosclerosis lesions characteristic of diabetes. Direct ophthalmoscopy and fluorescein angiography demonstrated a picture of advanced proliferative diabetic retinopathy. The patient had no history of diabetes mellitus and upon testing had normal glucose values in response to an oral glucose tolerance test. Insulin response to an intravenous glucose tolerance test was abnormally low. It is concluded that the nodular glomerulosclerosis lesions and proliferative retinopathy, thought to be specific for diabetes mellitus, may present in the absence of either overt clinical diabetes or impaired glucose tolerance.
Diabetes Care
PMID:Diabetic nephropathy and proliferative retinopathy with normal glucose tolerance. 404 6

Cholesterol of high density lipoproteins (Ch HDLP) was assayed in primary hyperlipoproteinemia (HLP) in patients with coronary heart disease (CHD) and in secondary HLP that developed in the presence of chronic glomerulonephritis with the nephrotic syndrome, hypothyrosis, diabetes mellitus, and lipoprotein metabolism disturbances innduced by longterm oral contraceptive adminnistration. In patients with primary HLP and the nephrotic syndrome, the Ch HDLP level was found to be reduced, this reduction being more manifest in hypertriglyceridemia; the reverse correlation between Ch HDLP and triglyceride content in the blood was observed. In patients with diabetes mellitus and hypothyrosis, Ch HDLP concentration was found to grow parallel with hypertriglyceridemia degree. Simultaneously, hypertriglyceridemia and hyper-Ch-HDLP were found in the blood under the effect of OCs. High levels of Ch HDLP during OC intake were found to depend on accumulation of cholesterol ethers in them, whereas in diabetes mellitus and hyperalphalipoproteinemia, detected in male subjects during prophylactic examinations, high levels of Ch HDLP were found to be related to the accumulation of free cholesterol. Study of the ratio of free and bound cholesterol in HDLP allows a differentiation between physiologic and pathologic hyper-Ch-HDLP; in physiologic hyperalphaproteinemia, cholesterol ethers were found to accumulate in HDLP, in pathologic ones, free cholesterol. At the same time, study of the cholesterol/phospholipid ratio gives an idea of the ability of HDLP to take hold of cholesterol from the peripheral cell membranes. Except for estrogen-induced lipoprotein metabolism disturbances, hyperalphalipoproteinemia in HLP is a sign or progressing lipoprotein metabolism disturbances. (author's modified)
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PMID:[High density lipoprotein cholesterol in secondary hyperlipoproteinemias]. 620 50


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