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

The renal effects of the prostaglandin synthesis inhibitor naproxen was investigated in eight patients with incipient type I diabetes nephropathy. The patients were treated with 1000 mg naproxen daily for 4 days in a placebo-controlled double-blind cross-over study. Naproxen reduced urinary prostaglandin E2 (PGE2) excretion by 60%, from 276 ng/24 h to 110 ng/24 h (P less than 0.05). Plasma renin activity (PRA) was reduced by 45% (P less than 0.05). Glomerular filtration (GFR) (single bolus 99mTc-DTPA technique) and effective renal plasma flow (ERPF) (131I-Hippuran clearance) were unchanged by naproxen. Microalbuminuria and renal albumin clearance was unchanged as was also urinary excretion of sodium, glandular kallikrein and beta 2-microglobulin (beta 2-M). Our results show that albumin excretion in incipient diabetic nephropathy is not solely dependent on the renal prostaglandin system. The difference in action between naproxen in this study and indomethacin in previous reports, could be caused by renal actions of indomethacin independent of the prostaglandin system.
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PMID:Effects of short-term treatment with naproxen on kidney function in insulin-dependent diabetic patients with microalbuminuria. 181 19

The roles of blood pressure and glomerular filtration rate in the renal handling of albumin, beta 2-microglobulin and sodium were studied by partial correlation analysis in 22 patients with glomerulonephritis and in 25 patients with diabetic nephropathy. The analysis showed that in these proteinuric patients blood pressure may have an independent role in the regulation of albumin excretion in both diseases. Fractional beta 2-microglobulin clearance and fractional excretion of sodium correlated significantly in both diseases. In the diabetic patients this correlation remained strong after removing the effect of blood pressure, whereas in the patients with glomerulonephritis control of blood pressure clearly decreased the correlation. This reflects differences in the renal handling of sodium and beta 2-microglobulin in patients with diabetic nephropathy and glomerulonephritis.
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PMID:Interrelations of blood pressure, glomerular filtration rate, protein clearances and sodium excretion in patients with glomerulonephritis and diabetic nephropathy. 211 24

Pravastatin, a novel inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, was administered to nine hypercholesterolemic patients with diabetes mellitus to examine its effects on diabetic nephropathy. Pravastatin treatment resulted in lowering serum total cholesterol by 22.1% on the average (p less than 0.001), and led to a significant reduction in urinary excretion of albumin and beta 2-microglobulin in patients with an elevated urinary protein excretion rate at the baseline period. But glycemic control, blood pressure, urinary excretion of creatinine and that of N-acetyl-beta-D-glucosaminidase showed no significant change during the study. These results suggest that reduction of atherogenic lipids and lipoproteins with pravastatin could alleviate diabetic glomerular injury.
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PMID:Amelioration of proteinuria with pravastatin in hypercholesterolemic patients with diabetes mellitus. 212 49

The nature and origin of proteinuria in diabetes mellitus have been investigated by measuring the urinary excretion of seven specific proteins of low (beta 2-microglobin, retinol-binding protein) or high molecular weight (albumin, transferrin, hemopexin and IgG). Using the Alcian Blue binding test, we also measured negative charges on red blood cell (RBC) membrane which according to recent studies might mirror the glomerular polyanion charge. A group of 190 diabetics was examined, including 90 patients with type I diabetes, 23 type II diabetics treated with diet and/or hypoglycaemic agents and 77 longstanding type II diabetics requiring insulin therapy. With the exception of beta 2-microglobulin all proteins measured were excreted in the urine of diabetics in significantly higher amounts than in controls. The assay of transferrin proved the most sensitive (58% positive) followed by albumin (49%), IgG (34%), hemopexin (28%) and retinol-binding protein (26%). Practically the same ranking was obtained when only type I diabetics were considered. RBC membrane negative charges were diminished in diabetics and negatively correlated with the urinary excretion of albumin (r = -0.61, n = 190). RBC charges were also negatively correlated with other urinary proteins of high molecular mass (r between - 0.5 and - 0.2) but presented no relation with urinary beta 2-microglobulin or retinol-binding protein. The loss of RBC charges in diabetics most likely reflects the concomitant depletion of the glomerular polyanion responsible for the increased glomerular leakage of high molecular mass plasma proteins. The preferential increase in transferrin excretion together with the progressive rise in the urinary excretion of IgG lead us to postulate that the loss of glomerular polyanion in diabetes is accompanied, from the early stage, by a progressive decrease in the size-selectivity of the glomerular filter. The urinary excretion of retinol-binding protein was weakly correlated with albuminuria (r = 0.26, n = 186). Eight % of diabetics showed an elevation of urinary retinol-binding protein without evidence of microalbuminuria, which clearly demonstrates that a proximal tubular impairment can occur independently of the glomerular alterations in the course of diabetic nephropathy.
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PMID:Urinary proteins and red blood cell membrane negative charges in diabetes mellitus. 225 3

To determine the specificity of the urine excretion of albumin as a measure of glomerular permeability in early insulin-dependent diabetic nephropathy, the effect of variable glomerular filtration and urine flow rates on albumin, beta 2-microglobulin excretion, and the fractional renal clearance of neutral dextran (Stokes Einstein Radius 24-46 A) was examined. Five insulin-dependent diabetic subjects with normal glomerular permeability (albumin excretion less than 30 micrograms/min) and one with elevated albumin excretion (195 micrograms/min) were studied pre and post strict glucose control with constant subcutaneous insulin infusion for 7 days. The albumin excretion in the 5 subjects never exceeded 30 micrograms/min during wide variations in glomerular filtration and urine flow rates. A positive correlation between beta 2-microglobulin excretion and urine flow (r = 0.81), and glomerular filtration (r = 0.77) rates was observed. In contrast, albumin excretion showed no correlation, indicating different factors affect the excretion rate of albumin and beta 2-microglobulin. Therefore, elevated albumin excretion (greater than 30 micrograms/min) in insulin-dependent diabetes is due to increased glomerular permeability and not changes in glomerular filtration and urine flow rates, and the albumin/ beta 2-microglobulin ratio may not be a valid indicator of changing glomerular permeability. The fractional neutral dextran clearances remained unchanged with variation in glomerular filtration and urine flow rates. The sieving curve was identical in all subjects for neutral dextran 40 A, the size of albumin, suggesting that reduced glomerular charge selectivity may contribute to increased albuminuria in progressive diabetic glomerulosclerosis.
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PMID:Factors affecting the urinary excretion of albumin in insulin-dependent diabetes. 244 93

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

Plasma inactive renin concentration (IRC) was determined in 92 diabetic patients with or without chronic diabetic complications, 23 non-diabetic patients with renal failure and 36 normal subjects. IRC of the diabetics was higher than that of normal persons. With the Pearson's correlation analysis, IRC of the diabetics correlated with duration of diabetes, degrees of chronic complications (nephropathy, retinopathy and neuropathy), but not with age of patient, HbA1c or mean blood pressure. The stepwise logistic analysis revealed the relation of neuropathy to mean blood pressure, serum creatinine concentration and duration of diabetes, retinopathy to mean blood pressure, duration of diabetes and serum beta 2-microglobulin and nephropathy to IRC and urinary NAG/Cr ratio. In addition, IRC was dependent on nephropathy but not on retinopathy or neuropathy. IRC in diabetics was high even in diabetics without albuminuria (group I) and significantly increased in diabetics with albuminuria but without increased serum creatinine level (group II) and more marked high levels were observed in diabetics with increased serum creatinine concentrations (group III). However, IRC of the non-diabetic patients with renal failure was not elevated, therefore, the increased IRC in nephropathy is likely to be specific to diabetic nephropathy. The correlation of other factors to increased IRC level seem to be due to nephropathy concomitant to these factors. Therefore, the increased level of IRC in diabetics is intimately connected to renal change in diabetes but whether it is the cause or result of nephropathy remains to be elucidated. It is concluded that the determination of IRC in diabetic patients was an effective means of assessment or forecast of nephropathy.
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PMID:[A study on inactive renin in the plasma of patients with diabetes mellitus]. 267 Jul 25

High diagnostic significance of beta 2-microglobulin determination by radioimmunoassay in the blood and urine of patients with the main types of renal pathology (chronic glomerulonephritis, chronic pyelonephritis, hemorrhagic fever with the renal syndrome, and diabetic nephropathy) was shown. A study of beta 2-microglobulin level permitted accurate determination of the localization of pathology in the nephron and assessment of a degree of its expression as well as the detection of initial renal functional disorders, assessment of therapeutic efficacy and dynamic observation of renal function in patients with renal pathology.
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PMID:[Clinical importance of the radioimmunologic determination of beta 2-microglobulin in patients with kidney pathology]. 290 87

Beta-thromboglobulin (beta TG) is a platelet-specific protein and since its concentration in plasma rises when platelets are activated, it has been used as an indicator of platelet involvement in vascular disease. Since platelets might be involved in the pathogenesis of diabetic microvascular disease we measured urinary beta TG in 20 insulin-dependent diabetics with nephropathy and compared the results with those from 20 normal subjects. Measurement of beta TG in urine was undertaken to avoid errors induced by blood sampling and to gain information over a prolonged period using a single assay. Measurements were made of beta TG, beta 2-microglobulin and total protein in urine collected for 24 h and creatinine and beta 2 microglobulin in plasma. Survival of indium-111-labeled platelets was measured in nine patients. Urinary beta TG was significantly (p less than 0.02) increased in the 20 patients compared with 20 normal volunteers (median value 1.3 vs 0.8 microgram/24 h). There was a strong correlation between urinary beta TG excretion and plasma creatinine concentration (r = 0.8, p less than 0.0001) and plasma beta 2-microglobulin concentration (r = 0.9, p less than 0.0001). Urinary beta TG concentration did not correlate with platelet survival. The results indicate that although urinary beta TG is significantly increased in patients with diabetic nephropathy its concentration in urine correlates with indicators of glomerular filtration rather than with a test of platelet activation.
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PMID:Urinary beta-thromboglobulin correlates with impairment of renal function in patients with diabetic nephropathy. 294 92

To examine whether plasma and urine concentrations of human atrial natriuretic peptide (hANP) are altered in patients with diabetes mellitus (DM), plasma and urine hANP concentrations were evaluated in 86 patients with diabetes mellitus using an extraction procedure. The mean recovery rate of extraction was 71.8 +/- 0.6% (mean +/- SEM). The major immunoreactive component of hANP in extracted plasma and urine appeared to be identical to synthetic alpha hANP as judged by reverse-phase high-performance liquid chromatography (HPLC). The patients were divided into three groups according to their renal complications. The patients in group 1 had no apparent abnormality in serum creatinine, serum or urine beta 2-microglobulin (beta 2-MG), or urine N-acetyl-beta-D-glucosaminidase (NAG); those in group 2 showed either beta 2-MG or NAG abnormality but no creatinine abnormality. The patients in group 3 were though to have an established diabetic nephropathy and showed a serum creatinine increase. Plasma ANP concentrations in groups 1, 2, and 3 were 10.7 +/- 2.1, 19.9 +/- 5.6, and 39.2 +/- 9.9 fmol/ml, respectively. These values in groups 2 and 3 were significantly higher than the control values (p less than 0.05 or p less than 0.01 versus 6.2 +/- 0.7 fmol/ml). Urine ANP concentrations in group 1 were also within normal range, though those in groups 2 and 3 markedly increased in comparison with normal values.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Plasma and urine concentrations of atrial natriuretic peptide in patients with diabetes mellitus. 297 69


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