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Query: UMLS:C0011860 (
type 2 diabetes
)
57,723
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
In order to investigate the influence of aldehyde dehydrogenase 2(ALDH2) genotype in the pathogenesis of nephropathy due to
non-insulin dependent diabetes mellitus
(
NIDDM
), genotyping of ALDH2 was measured using the PCR-RFLP method in patients with
NIDDM
on chronic hemodialysis (HD). The results were as follows; 1) The frequency of active ALDH2 was 63% and that of inactive ALDH2 was 37%. 2) The percentage of active ALDH2 was significantly higher in patients with alcohol tolerance than that in those without it (38%). 3) The estimated amount of alcohol consumption in the past was 506 +/- 720 g/week in the active ALDH2 group, and 156 +/- 288 g/week in the inactive ALDH2 group, showing a significant difference between the two groups. 4) Interdialytic body weight gain was larger in patients with active ALDH2 than in those with inactive ALDH2. Since the frequency of active ALDH2 was similar to that in patients without nephropathy, these results do not support the hypothesis that ALDH2 gene polymorphism is involved in the development and persistence of
chronic renal failure
due to
NIDDM
. However, salt and water craving in dialysis patients may be influenced partially by an active ALDH2 gene.
...
PMID:[Aldehyde dehydrogenase 2(ALDH2) gene polymorphism in NIDDM patients with chronic renal failure]. 975 91
Thirty-two patients with diabetes mellitus (22 IDDM and 10
NIDDM
, 21 males and 11 females, age 44+/-11.8 years) were followed for 5.2+/-3.8 years after the onset of
chronic renal failure
, with the aim of evaluating the effect of low protein diets on the rate of decline of the residual renal function. During the 1.8+/-1.6 year follow-up period on free or uncontrolled low protein diet the mean rate of decline of creatinine clearance was 0.9+/-0.6 ml/min/month, significantly greater than that observed during 3.7+/-3.1 years on low or very low protein diets. The reduction of protein intake was followed by a significant decrease in daily urinary protein loss. A better glycaemic control was obtained on the low protein diet, and the daily insulin requirement decreased. The anthropometry, as well as the serum concentrations of rapid turnover proteins, did not change, in spite of the low or very low protein dietary supply for a long duration. The values of mean arterial pressure were quite similar during the follow-up period on free or uncontrolled low protein diet and during the study period on the low protein diet. A good compliance with reduced dietary intake (as demonstrated by the measurement of the daily urea excretion) was obtained in a large number of patients. In conclusion, our study confirms the protective effect on the residual renal function of low protein diets in IDDM and
NIDDM
patients with
chronic renal failure
due to diabetic nephropathy, in the absence of any sign of protein malnutrition.
...
PMID:Dietary treatment of diabetic nephropathy with chronic renal failure. 987 Apr 26
Present study analyses nephroprotective effect of various therapeutic interventions at different stages of kidney involvement in diabetes mellitus. A MEDLINE search of past 10 years data on various experimental studies, controlled clinical trials, meta-analysis and editorials pertaining to nephroprotection in diabetes mellitus was made. Effect of various therapeutic interventions such as metabolic glycaemic control, restricted protein diet and antihypertensive drugs (especially ACE inhibitors) has been analysed on the progression of different stages of kidney involvement in diabetes mellitus such as normoalbuminuria, microalbuminuria, diabetic nephropathy and
end stage renal disease
(
ESRD
). An attempt has been made to analyse differential long-term impact of various therapeutic interventions in relation to type of diabetes mellitus (i.e., IDDM and
NIDDM
) and associated hypertension. Progression of IDDM patients having microalbuminuria or diabetic nephropathy with or without hypertension has improved during the past decade largely because of adequate glycaemic control and effective antihypertensive treatment with conventional drugs e.g. beta-blockers and calcium antagonists, and more so due to the use of ACE inhibitors e.g. captopril, enalapril etc. Superiority of ACE inhibitor tends to decline from normotensive stage to the degree of rise in systemic blood pressure. However, data in
NIDDM
patients suffering from diabetic nephropathy is incomplete and inconclusive.
...
PMID:Nephroprotection in diabetes mellitus. 1005 45
In Italy, as in all industrialized countries, life expectancy is raised during the past 100 years; this trend leads to important implications in medicine and among nephrologists. The increased number of
end stage renal disease
patients living beyond 65 years, who start dialysis, has modified the typical picture in dialysis centers. The causes of this phenomenon are different, including an increasing number of chronic diseases, typical of the "third age", like
type II diabetes mellitus
or vascular disease, creation of treatment facilities and success of prevention. Besides goods results obtained in elderly dialysis patients, mainly due to a better psychological reaction to the treatment and to an easy achievement of a high dialytic dose (Kt/V), there are some negative aspects, like the hemodynamic intolerance or the difficulties to make an ideal vascular access. However, these problems don't discourage the nephrologist but rather they must lead to achieve a personalized or alternative treatment. Even if the quality of life and rehabilitation are quite acceptable in many elderly patients, so to justify the wide acceptance criteria, many ethical and medical problems concern the most serious cases. Also in this condition, a wide acceptance criteria, followed by a possible withdrawal (time limited trial of treatment), can represent a reasonable solution.
...
PMID:[Dialysis in the elderly. Indications for and efficacy of hemodialysis]. 1042 15
The Otsuka Long-Evans Tokushima Fatty (OLETF) rat is a new diabetic strain of rats whose disease closely resembles human
type 2 diabetes
. We measured plasma adrenocorticotropic hormone (ACTH) and corticostrone levels, and iodine-125-labeled ovine corticotropin-releasing factor ([125I]oCRF) binding in the anterior pituitary after ether-laparotomy stress in OLETF rats to examine the alteration of the hypothalamic-pituitary-adrenal (HPA) axis. In addition, we examined ACTH secretion following
CRF
administration in vivo and in vitro to characterize the mechanisms regulating the HPA axis in OLETF rats. Body weight, plasma glucose and insulin levels in OLETF rats were significantly higher than that in Long-Evans Tokushima Otsuka (LETO) rats. Basal plasma ACTH levels tended to be higher in OLETF rats than in LETO but it did not reach statistical significance. Ether-laparotomy stress dramatically increased plasma ACTH levels at 2 h after the stress both in either OLETF and LETO rats; the peak plasma ACTH level in OLETF rats following the stress was significantly greater than in LETO rats. Plasma ACTH levels following
CRF
(2 microg/kg, i.v.) in OLETF and LETO rats showed statistically significant increases at 10 and 30 min after
CRF
administration compared to ACTH levels at 0 min, however, the peak plasma ACTH level in OLETF rats at 10 min after
CRF
administration was significantly greater than in LETO rats. In contrast to ACTH levels, no significant differences in corticosterone levels between OLETF and LETO were observed at any of the time points.
CRF
(10 ng/ml) significantly increased ACTH secretion in pituitary cultures from OLETF compared to LETO rats. These data reveal a complex regulation of the endocrine system in this diabetic condition and suggest that HPA axis may be more stimulated during acute stress in diabetes mellitus than in unaffected subjects.
...
PMID:Increased adrenocorticotropin responses to acute stress in Otsuka Long-Evans Tokushima Fatty (type 2 diabetic) rats. 1066 2
ESRD
is always fatal unless recognized and treated appropriately. In the United States, the incidence of
ESRD
is increasing. Fortunately, both mortality among dialysis patients and the rate at which
ESRD
has been increasing over the past decade are declining. Obviously, the primary goal should be prevention of
ESRD
. Aggressive treatment of hypertension and hyperglycemia is likely to reduce the incidence of
ESRD
. Screening for diabetes and hypertension may be a fruitful approach to reduction in
ESRD
rates, because many patients present with renal failure after prolonged periods of undiagnosed hypertension or
type 2 diabetes
.
...
PMID:Trends in end-stage renal disease. Epidemiology, morbidity, and mortality. 1091 23
Leptin is a protein hormone produced predominantly by adipocytes that affects food intake and energy expenditure. Its serum levels are significantly higher in patients with
chronic renal failure
compared to healthy subjects. The aim of this study was to compare serum leptin levels in hemodialyzed patients with
type II diabetes mellitus
(n=26) with body content-matched hemodialyzed patients without diabetes (n=26) and to explore the relationship between parameters of the long term diabetes metabolic control and serum leptin levels. Serum leptin levels in diabetic patients did not significantly differ from those of non-diabetic patients (25.3+/-8.8 vs 25.7+/-8.7 ng/ml). Serum leptin levels in diabetic patients positively correlated with body fat content, body mass index and predialysis serum insulin levels. No significant relationship were observed between serum leptin levels and blood glucose, glycated hemoglobin, glycated protein, serum urea, creatinine, leukocyte count and total hemoglobin respectively. The multiple stepwise regression analysis revealed that body fat content together with body mass index accounted for 77.8% of variations in predialysis serum leptin levels, while insulin levels and the parameters of diabetes metabolic control had only slight prediction value for leptin concentrations. We conclude that serum leptin levels in hemodialysed patients with type III diabetes mellitus do not significantly differ from those of hemodialysed non-diabetic patients. The body fat content and body mass index are the strongest predictors of serum leptin levels, while parameters of long term diabetes metabolic control play probably only minor direct role in its regulation.
...
PMID:Serum leptin levels in diabetic patients on hemodialysis: the relationship to parameters of diabetes metabolic control. 1092 55
Duplex Doppler sonography has been reported to be useful in examining the intrarenal hemodynamic abnormalities in various renal diseases. We investigated the impact of diabetes on intrarenal hemodynamics in patients with
chronic renal failure
(
CRF
). The resistive index and pulsatility index of the renal interlobar arteries were measured using duplex Doppler sonography in 90
CRF
patients (serum creatinine >130 and <800 mmol/l, mean age 59 +/- 11 years). Forty-eight patients had
type 2 diabetes
and 42 did not. Twenty-nine age-matched, healthy subjects served as controls. Both resistive index and pulsatility index were greater in
CRF
patients than in the controls (p < 0.0001). No significant differences existed in age, sex, body mass index, total serum cholesterol, serum creatinine, estimated creatinine clearance, or mean blood pressure between the diabetic
CRF
and nondiabetic
CRF
groups. Resistive index and pulsatility index were significantly increased in the diabetic
CRF
patients compared to the nondiabetic
CRF
patients (p < 0.0001). Multiple regression analysis of all
CRF
patients revealed that resistive index was independently affected by the presence of
type 2 diabetes
(F = 44.535), as well as decreased creatinine clearance (F = 18.157) and age (F = 15.160) (R(2) = 0.559, p < 0.0001). These results clearly demonstrated that intrarenal arterial resistance is significantly increased in
CRF
patients with
type 2 diabetes
compared to similar patients without diabetes. The impact of diabetes mellitus and advanced age on intrarenal hemodynamics may be due to intrarenal arteriosclerosis and interstitital lesions. Measurements of RI values in addition to conventional ultrasound imaging may add further information on such renal lesions.
...
PMID:Diabetes mellitus worsens intrarenal hemodynamic abnormalities in nondialyzed patients with chronic renal failure. 1097 Nov 52
Chronic renal failure
is an unusual complication of hereditary clotting disorders (HCDs), but this situation could change in the near future. The modality of dialysis for end-stage renal disease (ESRD) in patients with an HCD is a difficult choice. Hemodialysis (HD) may be considered, but intensive treatment with coagulation factors is required for vascular access execution and for each HD procedure. Peritoneal dialysis (PD) has been infrequently proposed. However, PD requires coagulation replacement therapy only during peritoneal catheter placement. The aim of this paper is to describe our experience of three patients with ESRD and HCD, successfully treated with chronic PD in the medium term. Case 1 was a 58-year-old man with moderate hemophilia A,
type 2 diabetes
mellitus, and hepatitis C virus (HCV) infection. His ESRD was secondary to glomerulonephritis. A double-cuff peritoneal catheter was surgically placed with pre-emptive factor VIII administration. He began treatment with continuous ambulatory peritoneal dialysis (CAPD). An inguinal hernia was repaired without complications. After eleven months of follow-up, no hemorrhage episodes have been observed and clinical outcome is optimal. Case 2 was a 46-year-old man with severe hemophilia A,
type 2 diabetes
mellitus, and HCV and human immunodeficiency virus (HIV) infections. He developed a diabetic nephropathy that required renal replacement therapy. A permanent silicone catheter was inserted in the left internal jugular vein, and the patient started HD treatment. Later on, PD therapy was proposed. A peritoneal catheter was implanted with simultaneous factor VIII infusion. Minimal bleeding was observed at the subcutaneous tunnel over the following 48 hours. The patient started PD treatment without complications, and two months later, remaining asymptomatic, transferred to another center. Case 3 was a 41-year-old woman diagnosed with von Willebrand disease type 2A, HCV infection, and polycystic kidney disease, who presented with ESRD. An internal arteriovenous fistula was performed under coagulation factor cover. During a fistulography, and despite coagulation factor substitutive treatment, the patient showed an important hematoma. Afterwards, PD was considered. A peritoneal catheter was implanted under coagulation factor cover. The postoperative course was uncomplicated, and the patient started CAPD treatment. During follow up, she suffered two hemoperitoneum episodes that were resolved with cold dialysate. After nine months, she uneventfully continued on PD. In conclusion, PD is the therapy of choice for patients with hereditary clotting disorders and ESRD requiring dialysis. Peritoneal dialysis therapy avoids many of the complications related to HD therapy.
...
PMID:Peritoneal dialysis is the therapy of choice for end-stage renal disease patients with hereditary clotting disorders. 1104 86
To analyze the contribution of MHC class II genes in
type 2 diabetes
mellitus (DM) with
end stage renal disease
(
ESRD
), we examined the distribution of HLA-DRB1, DQA1, DQB1 loci in Mexican Mestizos of Central Mexico, using PCR-SSOP and PCR-SSP. Three groups were included: 47 type 2 diabetic
ESRD
patients; 42 patients with
ESRD
and 50 type 2 DM patients with no kidney complication. The results were compared with those of 101 controls of the same area. The median since DM was first diagnosed, was 18 years prior to the onset of
ESRD
. The frequencies of DRB1*1502 and DQB1*0501 were increased in DM patients with
ESRD
(p = 0.004; RR = 7.4, CI = 1.5-37; EF = 0. 13; p = 0.007; RR = 2.9, CI = 2.3-3.5, EF = 0.21, respectively). In contrast, DRB1*0407 was decreased in the same group (p = 0.0008, RR = 0.2; CI = 0.035-0.70, PF = 0.19). Diabetic patients with DRB1*1502 are 8.8 times more likely to develop
ESRD
, independently of the duration time of DM. DRB1*1502 contributes to the susceptibility to
ESRD
while DRB1*0407 is involved in protection. The residue at DRB1-74 differs in these alleles: DRB1*0407 has glutamic acid and DRB1*1502 has an alanine, suggesting that this substitution may be important for both, peptide anchoring and for presentation to the T cells.
...
PMID:Contribution of HLA class II genes to end stage renal disease in mexican patients with type 2 diabetes mellitus. 1108 16
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