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)

In the second morning urine of 51 patients with diabetes mellitus (type I/II) albumin, N-acetyl-beta-D-glucosaminidase (NAG), alpha 1-microglobulin (alpha 1-M/U), creatinine (reference parameter) as well as serum alpha 1-microglobulin and creatine were determined. Following an international expert recommendation, three groups were formed depending on albumin excretion: group 1: albumin less than 24 mg/g creatinine (normal range) group 2: albumin greater than 24 mg/g creatinine and less than 200 mg/g creatinine (so called microalbuminuria) group 3: albumin greater than 200 mg/g creatinine (manifest proteinuria) The urinary tubular parameters NAG and alpha 1-microglobulin were above normal range in 17 and 21% respectively in group 1. For group 2 the results were abnormal in 94 and 69% and for group 3 in 100% of patients. Albuminuria correlated with NAG activity, but not with alpha 1-microglobulin excretion. These results indicate, that measuring NAG and alpha 1-microglobulin as markers for tubular dysfunction can give additional diagnostic informations about type and degree of diabetic nephropathy.
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PMID:[Urinary proteins in patients with diabetes mellitus]. 247 8

We assessed in a pilot study the effect on some aspects of renal function of 6 weeks' administration of a combination of aspirin-dipyridamole (990 mg/225 mg daily) administered on a double-blind crossover schedule in 16 insulin-dependent diabetic patients with nephropathy. Total 24-h urinary protein excretion (16 patients) was significantly reduced during aspirin-dipyridamole administration from a geometric mean (range) of 1.9 (0.4-7.7) g/24 h to 1.4 (0.5-9.9) g/24 h (2P less than 0.05). Indium-labelled platelet survival (eight patients), glomerular filtration rate and renal blood flow (eight patients) showed no significant change following aspirin-dipyridamole therapy, even though plasma creatinine concentration increased from 118 (65-371) to 130 (76-438) mumol/l (2P less than 0.05). Diabetic control and blood pressure remained unchanged throughout the study. Although the results showed that this treatment significantly reduced proteinuria in patients with diabetic nephropathy, the mechanism of action was not entirely clear.
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PMID:Administration of aspirin-dipyridamole reduces proteinuria in diabetic nephropathy. 249 57

We show our experience, results and complications with Intermittent Peritoneal Dialysis (IPD). We treated with this technique 28 patients with end stage renal disease (ESRD), between 1981-1988; (24 adults, 8 of them with diabetic nephropathy (6 non insulin dependent diabetic patients and 4 children) for 3 to 36 months. IPD was well tolerated. The extracellular volume control, haematocrit and plasma protein values, as well as, ac-base equilibrium nutritional status, ureic nitrogen and creatinine plasma levels, were fully satisfactory. There was statistical difference only in the Na+ (p less than 0.001), alkaline phosphatases (p less than 0.005), glucose (p less than 0.05) plasma values and glycosylated hemoglobin (p less than 0.05), between diabetics and non diabetics group. The peritonitis rate was 0.065 and 0.074 peritonitis/patients-month; respectively (NS) and were caused by Gram (-) bacteria. St Aureus and St Epidermides. The survival curves of patients and method, in both groups, were similar (NS). We conclude IPD is a good alternative of therapy for ESRD, also for diabetics patients, whom haven't got more infection rate than non diabetics patients.
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PMID:[Intermittent peritoneal dialysis: a 6 years' experience]. 251 81

Renal functional parameters including creatinine clearance, urinary albumin excretion, basement membrane thickening, and levels of nonenzymatic glycation of glomerular basement membrane were studied in streptozotocin-induced diabetic rats and age-matched controls subjected to low protein diet. In addition, these parameters were also assessed in diabetic and streptozotocin injected nondiabetic animals fed a 24% protein diet, which served as "positive controls." While diabetic animals from both diet groups had similar elevated glycated hemoglobin levels and increased levels of nonenzymatic glycation of glomerular basement membrane, these were significantly elevated as compared to insulin treated diabetic (euglycemic), age-matched controls on an 8% protein diet, and streptozotocin injected nondiabetic animals from both diet groups. However, urinary albumin excretion and creatinine clearance levels were significantly elevated only in the 24% protein diet fed diabetics over values seen in the various groups of animals on 8% and controls on 24% protein diet. In contrast, there were no statistical differences among diabetic, euglycemic and control (8% and 24% protein) animals with respect to creatinine clearance, urinary albumin excretion, and glomerular basement membrane thickness. Taken together these data cast some doubt on the role of nonenzymatic glycation in the development of diabetic nephropathy. Moreover, hyperglycemia per se causes a compensatory increase in kidney size irrespective of protein intake; a low protein diet, however, inhibits the hyperfiltration commonly seen in early diabetic nephropathy. The authors, thus, hypothesize that a low protein diet, by preventing compensatory increase in blood flow to surviving nephrons, in some fashion protects these functional units from subsequent damage and possibly delays the onset of renal failure.
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PMID:Effect of a low protein diet on the relationship of nonenzymatic glycation to altered renal structure and function in diabetes mellitus. 252 37

The prevalence of diabetic nephropathy among the German Democratic Republic (GDR) population is substantial, as is true of many other countries. An epidemiologic survey performed in the county of Neubrandenburg revealed increased creatinine values in 44.9% of diabetics with diabetes duration greater than 15 years, and in 24.9% of those with the disease less than 15 years. Given these data, the prevalence of renal insufficiency due to diabetic nephropathy is estimated as 27/100,000 in diabetics with greater than 15 years, and 9/100,000 in diabetics with less than 15 years of diabetes, including only patients up to the age of 49 years; this must be substantially greater when considering all age groups. Only 13% of all patients on chronic hemodialysis are diabetics. Although we offer each of our nephropathic diabetics such kidney replacement therapies as dialysis and transplantation, a substantial number of diabetics are not treated, presumably due to advanced macrovascular complications.
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PMID:Frequency and therapy of end-stage renal disease due to diabetic nephropathy in the German Democratic Republic. 252 38

There is evidence that increased excretion of urinary enzymes and low-molecular mass proteins indicate impaired tubular function. The excretion of N-acetyl-beta-D-glucosaminidase (NAG), lysozyme, and ribonuclease in Type I diabetic patients with (n = 19) and without (n = 17) persistent proteinuria (urinary protein excretion greater than 0.5 g/day) was investigated and compared with this excretion in 30 weight- and gender-matched nondiabetic subjects without renal disease. Urinary NAG excretion was significantly higher in diabetic patients with and without persistent proteinuria (1.16 +/- 0.09 and 3.19 +/- 1.2 Umol/L creatinine, respectively) compared to controls (0.37 +/- 0.03 Umol/L creatinine p less than 0.01). In addition, the urinary excretion of lysozyme and ribonuclease was significantly increased in diabetic patients. Urinary NAG was found to correlate positively with albuminuria and proteinuria (r = 0.95 and 0.93, respectively), as well as with ribonuclease and lysozyme (r = 0.93 and 0.60; p less than 0.01) in patients with persistent proteinuria. Furthermore, NAG excretion was significantly related to the duration of diabetes (r = 0.36; p less than 0.05). No relationship existed between urinary NAG and serum creatinine, beta-2-microglobulin, and degree of metabolic control (HbA7). The lysozyme excretion, but not NAG excretion, was significantly related to hypertension in patients with clinical proteinuria. In conclusion, our results suggest a relationship between the development of tubular dysfunction and the impairment of glomerular function in diabetic nephropathy. An increased excretion of NAG and low-molecular mass proteins may indicate early nephropathy
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PMID:Further evidence for tubular dysfunction in insulin dependent diabetes. 252 61

Streptozotocin (45 mg/kg) was intravenously administered to 7-week-old Wistar rats through their tail veins. After 11 days, the rats were divided into two groups. One group was fed a lipid-free diet (90%, w/w) plus lard (8%) and safflower oil (2%) for four weeks (Diet 1 group, n = 12). The other group was fed in the same way, except that safflower oil was replaced by 90% pure eicosapentaenoic acid (EPA) ethyl ester (Diet 2 group, n = 13). Twenty-four-hour urine was collected just before the diets started and during the experiment at 7-day intervals. In the second and third week, the levels of proteinuria were significantly lower in the Diet 2 group than they were in the Diet 1 group. There was no significant difference in the levels of creatinine, urea nitrogen, or lipids in plasma or in body weights between the two groups after four weeks on the diets. Because Diet 2 reduced proteinuria of diabetic rats compared to Diet 1, an EPA-rich diet may retard the development of diabetic nephropathy.
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PMID:Effect of eicosapentaenoic acid ethyl ester on proteinuria of streptozotocin-induced diabetes mellitus in rats. 255 48

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 effect of early antihypertensive treatment on survival of patients with diabetic nephropathy was evaluated by studying two cohorts of Type 1 (insulin-dependent) diabetic patients developing persistent proteinuria in I: 1957-1973 (late treatment group n = 49) and II: 1979-1983 (early treatment group n = 71). At onset of nephropathy, the two cohorts were comparable with regard to age (29(8) vs 30(8) years, mean (SD], duration of diabetes (16(6) vs 18(7) years), blood pressure (132(16)/85(11) vs 134(16)/86(8) mm Hg), proteinuria (0.8(0.5-1.2) vs 0.8(0.6-1.2) g x 24 h-1, median (quartiles] and serum creatinine (87(14) vs (85(16) mumol x 1(-1]. The patients were followed frequently at the outpatients' clinic until death or for a median duration of 8 years. In the first cohort antihypertensive treatment was seldom used, whereas, in the second cohort antihypertensive treatment was started when blood pressure reached 144(18)/93(7) mm Hg. The probability of survival with a functioning kidney for more than 8 years was 48% in the first cohort and 87% in the second cohort, p less than 0.001. The improvement of survival was due mainly to a decreased mortality from uraemia. Early antihypertensive treatment is the most likely explanation for this improvement.
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PMID:Improved survival in patients with diabetic nephropathy. 261 60

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


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