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Query: UMLS:C0011881 (diabetic nephropathy)
 10,836 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study was carried out on 55 diabetic patients, 20 of whom had diabetic nephropathy, and 10 controls. Glycosylated haemoglobin, glycosylated serum protein, glucoprotein, serum protein electrophoresis, blood urea, serum creatinine and beta 2-microglobulin were measured. A significant increase of glucoprotein was observed in patients with diabetic nephropathy. No correlation was found between glycosylated serum protein and glycosylated haemoglobin and duration of diabetes. Glycosylated serum protein showed a positive correlation with beta 2-microglobulin, indicating a link between renal involvement and the rise in glycosylated serum protein. Whether there is a pathogenic relation between glycosylated serum protein and the development of nephropathy awaits further evidence.
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PMID:Glycosylated proteins in diabetic nephropathy. 258 Dec 43

The effects of monotherapy with nicardipine, 20 mg three times a day, have been investigated in a 1-year study of 26 elderly (greater than 60 years) patients with hypertension with various types of renal dysfunction and seven without renal dysfunction. Parameters measured included blood pressure, blood chemistry (serum creatinine, uric acid, blood urea nitrogen, blood glucose total cholesterol, and electrolytes), plasma renin activity, and plasma aldosterone concentration. Nicardipine was effective in reducing blood pressure in all patients with diabetic nephropathy, parenchymal renal diseases, or hypertensive nephropathy, and in those without renal dysfunction. Serum creatinine and blood urea nitrogen levels were slightly elevated in some patients whose pretreatment serum creatinine level was greater than 2 mg/dl, regardless of the type of nephropathy. However, it was not determined whether this effect was the result of a reduction in blood pressure induced by nicardipine. Serum sodium, potassium, total cholesterol, and blood glucose levels were unchanged by the administration of nicardipine. Changes in plasma renin activity and aldosterone levels were not significant. These results suggest that nicardipine can be used safely in elderly patients with hypertension with renal dysfunction, regardless of the type of nephropathy.
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PMID:Effects of nicardipine on blood pressure and renal function in elderly hypertensive patients with renal dysfunction. 264 83

Low-protein diets in nondiabetic renal failure may slow the progressive loss of renal function in some patients, but few studies have detailed the nutritional consequences of these diets in patients with diabetic nephropathy. We studied 7 patients with insulin-dependent diabetes mellitus and chronic renal insufficiency [mean +/- SEM creatinine clearance (S, U): 28.3 +/- 6.5 ml/min (0.47 +/- 0.11 ml/s x 1.73/A)] for 15 weeks who were prescribed a diet of 0.6 g protein/kg ideal body weight. Midarm muscle circumference (24.1 +/- 1.8 at onset vs. 24.5 +/- 1.5 cm at completion), triceps skinfold thickness (21.6 +/- 3.1 vs. 21.0 +/- 1.5 mm), body weight (71.8 +/- 4.1 vs. 71.2 +/- 4.6 kg), and serum albumin [3.0 +/- 0.1 vs. 3.2 +/- 0.1 g/dl (30 +/- 1 vs. 32 +/- 1 g/l)] remained stable. Based on urinary nitrogen excretion, diet diaries overestimated the degree of dietary protein restriction; there was good adherence to the diet as evidenced by a reduction in urinary urea nitrogen (average 32%). Blood glucose control was maintained despite increased carbohydrate intake. On average, creatinine clearance did not change significantly, but proteinuria diminished slightly (1.8 +/- 0.2 vs. 1.5 +/- 0.6 g/day). These results indicate that 0.6 g/kg/day protein diets did not cause protein depletion in insulin-dependent diabetic patients. Longer-term studies are indicated to assess more fully the efficacy of these dietary regimens in reducing proteinuria or benefiting diabetic nephropathy.
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PMID:Protein-restricted diets in diabetic nephropathy. 271 Feb 67

Eleven patients with insulin-dependent diabetes, advancing renal insufficiency, and proteinuria were placed on a diet containing 0.6 g/kg per day of high-biologic-value protein. Selected clinical variables were observed over a 2-year interval. The rate of decline in renal function was significantly decreased during the intervals of protein restriction. The rate during the second 12 months of the study, however, was increased, when compared with the first 12-month interval. Urinary protein excretion decreased significantly, from 2.27 +/- 0.49 g/d to 0.57 +/- 0.40 g/d after the first 12 months of the study, but increased to 1.43 +/- 0.63 g/d after the second 12 months of the study. The dietary protein intake estimated from urea nitrogen excretion in urine samples correlated significantly with urinary protein excretion. These findings suggest that dietary protein restriction has a sustained beneficial effect on the course of diabetic nephropathy, if compliance to the diet can be maintained.
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PMID:Prolonged dietary protein restriction in diabetic nephropathy. 271 6

We examined clinical and laboratory features retrospectively in 402 patients at the start of chronic hemodialysis in order to define better the "uremic syndrome" in the dialysis era. The information gathered included demographic data, renal diagnoses, uremic symptoms, biochemical values, and prevalences of hypertension (69%), diabetes mellitus (23%) and ischemic heart disease (16%). Unexpected findings were the wide ranges of serum creatinine levels (3.5 to 35 mg/dl) and blood urea nitrogen levels (35 to 345 mg/dl), and the frequency of hyponatremia (27%), hypoalbuminemia (52%), and anion gaps above 25 mg/dl (5%). There were higher hematocrits in males and diabetics, lower serum creatinine levels in females, diabetics and older patients, and lower blood urea nitrogen levels in blacks. The time interval from diagnosis of diabetes mellitus to initiation of dialysis in patients with diabetic nephropathy due to juvenile-onset diabetes mellitus (20.6 +/- 6.8 years) was twice that in adult onset diabetes mellitus (10.3 +/- 8.3 years).
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PMID:Clinical and laboratory features of patients with chronic renal disease at the start of dialysis. 292 Apr 71

Some cardiovascular (heart rate and mean arterial pressure), and renal (glomerular filtration rate-GFR; renal plasma flow-RPF; filtration fraction-FF; blood urea nitrogen-BUN and albuminuria) parameters, coupled with morphologic examination, was undertaken in early (2 months) and late (6 months) stage of streptozotocin-induced diabetes mellitus in rats. The results showed a temporally (early) bradycardia and gradually increase of blood pressure with morphologic changes typical for diabetic cardiopathy. The increased GFR (by 92%), associated with significantly decreased RPF (by 37%), increased FF (by 133%), increased kidney weight/body weight ratio (by 88%), increased BUN (by 52%) and distinct albuminuria (13.53 +/- 2.08 mg/24 h/100 g b. w.), together with typical morphologic changes, suggested the development of diabetic nephropathy which was progressive with the duration of the disease.
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PMID:Pathogenesis of cardiovascular disorders in streptozotocin-induced diabetes in rat. I. Cardiovascular, renal and morphologic changes in different stages of diabetes. 306 11

Proteinuria in diabetes is associated with progressive glomerular damage. We studied the effects of 3-wk dietary protein restriction on proteinuria and renal function in 10 insulin-dependent diabetic men with diabetic nephropathy. Patients were randomly assigned by a crossover design to 40-g low-protein diet (LPD) or usual-protein diet (UPD). Glomerular filtration rate and renal plasma flow were measured by inulin and p-aminohippurate clearance at the end of each period under conditions of sustained euglycemia. Total calorie intake, body weight, serum albumin and total protein concentrations, hematocrit, blood pressure, and glucose control were similar during the two diets. Achieved protein intake was 46 +/- 3 g/day during LPD and 81 +/- 4 g/day during UPD (P less than .001). Urinary urea appearance and plasma urea were significantly lower on LPD. Median total urinary protein was reduced from 3.9 g/day (range 0.5-12.3) on UPD to 2.4 (range 0.2-9.0) on LPD (P less than .006), and there was a significant fall in the median fractional clearance of albumin from 2.0 x 10(-4) (range 0.1-90.9) on UPD to 1.0 x 10(-4) (range 0.1-51.4) on LPD and IgG from 2.1 x 10(-5) (range 0.2-238) to 1.5 x 10(-5) (range 0.1-77) (P less than .006 and P less than .02, respectively). The reabsorption rate of beta 2-microglobulin was similar on the two diets and glomerular filtration rate, renal plasma flow, and filtration fraction remained unchanged. Thus, short-term dietary protein restriction reduces diabetic proteinuria independently of blood glucose or systemic blood pressure changes by improving glomerular permselectivity.
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PMID:Renal response to restricted protein intake in diabetic nephropathy. 319 38

Nephropathy continues to be the most serious complication in type I-diabetics. When we started chronic hemodialysis in these patients 15 years ago survival figures were poor. Later on the survival rate for diabetics undergoing hemodialysis has improved progressively. The aim of this report was to present our own experience in hemodialysis treatment of insulin-dependent diabetics. The cumulative survival rate of 46 insulin-dependent diabetics undergoing hemodialysis has increased progressively and now amounts to 70% after one year, and 50% after two years of treatment. At the same time we could attain a certain improvement of metabolic control. Nutrition has also been improved, as indicated by increased transferrin (p less than 0.05) and stable serum protein levels. Systolic blood pressure control became better (p less than 0.05) but, a fluid overload was still present. Here, further improvements are necessary to increase the survival rate. Therefore, the survival of diabetic patients with hemodialysis may be approaching that of non-diabetics. In some patients retinopathy was improved after one year of treatment. Despite a better prognosis for survival in diabetics treated by chronic hemodialysis we suggest that the successful renal transplantation should be the treatment of choice in patients suffering from diabetic nephropathy. In general, hemodialysis and renal transplantation should be started earlier than hitherto, i.e. already at creatinine levels of about 600 mumol/l, and at urea levels of 30 mmol/l. Strict metabolic and blood pressure control, as well as early laser coagulation therapy of retinopathy should be instituted for patients with creatine levels above 200 mumol/l, in close cooperation of a diabetologist, nephrologist, and ophthalmologist. This will be our future therapeutic strategy for these patients.
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PMID:Clinical course in insulin-dependent diabetics undergoing hemodialysis. 398 29

In this article we describe the successful management of pregnancy and delivery in a 26-yr-old patient with advanced diabetic nephropathy and chronic renal failure. Targets for control of blood urea and hemoglobin were achieved with the aid of continuous ambulatory peritoneal dialysis (CAPD). Peritoneal dialysis did not interfere with normal recovery from cesarean section. With CAPD, successful pregnancy is now possible in this group of patients, among whom fetal loss would otherwise be high.
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PMID:Successful pregnancy in a diabetic patient treated with continuous ambulatory peritoneal dialysis. 687 12

A survival analysis was applied to 1,453 patients treated between 1972 and 1978 in 33 French dialysis centers and prospectively followed up in the computerized Diaphane Dialysis Registry. 198 deaths (overall mortality = OM) were registered, of which 87 (43%) were secondary to cardiovascular complications (cardiovascular mortality = CVM). Risk factors for OM and CVM (p values less than 0.05) were age, male sex, nephroangiosclerosis or diabetic nephropathy as the primary renal disease, elevated systolic and diastolic blood pressure and two weekly dialysis rather then three. In contrast with the results observed for the general population, a high body mass index and elevated cholesterol, triglycerides and uric acid were not found to be associated with significantly increased CVM or OM. On the contrary, low body mass index (less than 20 kg/m2), low cholesterol (less than 4.5 mmol/l) and low mean predialysis blood urea (less than 4.6 mmol/l) were associated with increased OM and CVM, and more especially with high stroke mortality. Results for urea but not for cholesterol remain significant after adjustment for age, sex, weekly dialysis schedule and body mass index. They suggest that, in addition to elevated blood pressure, a poor nutritional state and/or low protein intake may be important factors for explaining the high cardiovascular mortality, particularly for strokes, observed in dialyzed patients.
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PMID:Mortality risk factors in patients treated by chronic hemodialysis. Report of the Diaphane collaborative study. 712 51


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