Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011881 (diabetic nephropathy)
 10,836 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Left ventricular diastolic function was assessed by pulsed Doppler echocardiography in non-diabetic controls (n = 11) and in patients with type 1 diabetes without microvascular disease (n = 16; diabetic controls), with microalbuminuria (n = 9), or with early persistent proteinuria (n = 11). The peak filling velocities during the early and atrial phases of left ventricular diastole and their ratio (E:A ratio) were measured. All patients with diabetes had a normal serum concentration of creatinine and exercise electrocardiogram. The mean E:A ratio was significantly lower in those with proteinuria than in the diabetic controls because of an increase in peak atrial filling velocity; most patients with proteinuria had an abnormal E:A ratio of less than 1.0. Multiple regression analysis showed that systolic blood pressure was the major determinant of both the peak filling velocity during the atrial phase of diastole and also left ventricular mass. Blood pressures were significantly higher in the proteinuria group than in the diabetic controls. Glycaemic control and autonomic function did not influence diastolic filling. The slightly raised blood pressures at the earliest stages of diabetic nephropathy are sufficient to alter left ventricular diastolic compliance--this may reflect early hypertensive heart disease. These data do not preclude a specific heart muscle disease related to diabetes, but suggest that these slightly raised blood pressures contribute significantly to left ventricular dysfunction in these patients, in whom the risk of cardiovascular disease is already greatly increased.
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PMID:Abnormal diastolic function in patients with type 1 diabetes and early nephropathy. 222 5

The incidence of end-stage renal disease (ESRD) has increased 9% a year over the past 10 years, due primarily to diabetic nephropathy and hypertensive nephrosclerosis. Over this period of time, mortality rates for hypertensive heart disease and stroke have decreased substantially, in large part because of greater recognition and improved therapy of hypertension. Why then is there an increasing incidence of ESRD in diseases in which hypertension plays a significant role in causation and/or progression of renal failure? Is it possible that a lower level of blood pressure than usually recommended is necessary to prevent kidney disease (particularly in blacks) or to prevent or slow progression in most forms of renal failure? Furthermore, are there specific renoprotective drugs? This report will focus primarily on large prospective studies that may provide information to answer these questions.
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PMID:Hypertension and chronic renal failure: the use of ACE inhibitors. 942 71