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Query: UMLS:C0730345 (microalbuminuria)
 4,018 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The plasma membrane Na+/H+ exchanger is a ubiquitous system which plays a role in the regulation of intracellular pH and the control of cell growth. In order to assess the potential role of this system in the pathogenesis of diabetic nephropathy, we investigate 42 normotensive insulin-dependent diabetic patients with or without microalbuminuria. We tested the platelet Na+/H+ exchange as the rate of amiloride sensitive and sodium dependent volume gain of cells suspended in sodium propionate. Urinary albumin excretion (UAE) was assayed by radioimmunoassay on a 24 h sample; the glomerular filtration rate (GFR) and the renal plasma flow were determined by 99 m Tc-DTPA and 1231 l-hippuran respectively. Thirty patients (group 1) had EUA > 30 mg/24 h (m +/- sd: 11 +/- 7 mg/24 h), 12 patients (group 2) had microalbuminuria (62 +/- 30 Mg/24 h, range from 35 to 136 mg/24 h). The platelet Na+/H+ exchange rate was significantly increased in patients of group 2: 0.34 +/- 0.01 versus 0.26 +/- 0.06 s-1 x 10(-2) (p < 0.005). There was no significant difference between these two groups regarding blood pressure (116 +/- 14/71 +/- 7 versus 119 +/- 12/73 +/- 5 mmHg), age, diabetes duration, glycated hemoglobin or fructosamine levels. On the whole population, we found a significant positive correlation between the platelet Na+/H+ exchange rate and the UAE (r = 0.57, p < 0.001) and with the glomerular filtration fraction (r = 0.43, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1992 Aug
PMID:[Activity of platelet sodium-proton exchanger, microalbuminuria and insulin-dependent diabetes]. 133 55

Angiotensin I Converting Enzyme (ACE), which is synthesized by vascular endothelial cells, can be elevated in some diabetic subjects. To study if serum ACE can be elevated in subjects with high risk for malignant microangiopathy, 34 normotensive type I, insulin-dependent diabetic subjects with persistent microalbuminuria (30-300 mg/24 h) were compared for serum ACE activity (Liebermann's method) with 30 normotensive, normoalbuminuric type I, insulin-dependent diabetic subjects of same age (33 +/- 15 (M +/- SD) vs 39 +/- 14 years), sex (13 F/21 M vs 15 F/15 M), stage of retinopathy (14 vs 16 nil/11 vs 7 background/6 vs 4 preproliferative/3 vs 3 proliferative), HbA1c (7.7 +/- .9 vs 8.2 +/- 1.0%). Serum ACE activity of diabetic subjects were also compared with 120 age and sex related healthy controls. Serum ACE activity was higher in type I, insulin-dependent diabetic subjects with microalbuminuria than in those with normoalbuminuria (406 +/- 114 vs 359 +/- 97 IU/l; p = 0.05), or in controls (307 +/- 95 IU/l; p = 0.0001). Normoalbuminuric subjects also had higher ACE activity than controls (p = 0.02). In diabetic subjects, serum ACE activity was not related to diabetes duration (r = 0.1; ns), stage of retinopathy (r = 0.06; ns), HbA1c (r = 0.02; ns), or to blood pressure (r = 0.03; ns), but was related to urinary albumin excretion (r = 0.28; p = 0.03) in diabetic subjects. However, stage of retinopathy was related to diabetes duration (r = 0.74; p = 0.0004) and to age (r = 0.42; p = 0.003) in these subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1992 Aug
PMID:[Increase of activity of angiotensin-converting enzyme in insulin-dependent diabetic patients with permanent microalbuminuria]. 133 56

Incipient diabetic nephropathy is characterized by a urinary albumin excretion (UAE) between 30-300 mg/24 h and a slightly elevated blood pressure. We measured blood pressure in 14 insulin-dependent diabetic subjects (IDDs) with persistent microalbuminuria (group A) and 50 IDDs with persistent normoalbuminuria (group B) using 3 different methods: 1) Sphygmomanometer, by a nurse, on supine position since 10 min, on the third day of hospitalization; 2) automatic device (Dinamap), on supine position, every 5 min, during 30 min; 3) ambulatory blood pressure (Spacelab 90202 every 15 min between 8 a.m. and 8 p.m.; values obtained with this last method were compared to the mean values of healthy subjects of same age. Recorded UAE was the median value of 3 twenty-four-hours urines. Blood pressure was not different among the two groups with any of the three methods: 1) SBP/DBP A: 136 +/- 14/81 +/- 9 vs B: 131 +/- 13/78 +/- 8 mmHg; ns; 2) SBP/MBP/DBP A: 134 +/- 17/96 +/- 12/79 +/- 10 vs B: 127 +/- 13/90 +/- 10/74 +/- 10 mmHg; ns; 3) A: 132 +/- 12/97 +/- 11/84 +/- 9 vs B: 127 +/- 11/91 +/- 9/82 +/- 12 mmHg; ns. There were no concordance between microalbuminuria/normoalbuminuria and systolic or diastolic blood pressure higher/lower than the mean of the healthy subjects (X2 = 1.6; ns). However, UAE was significantly related to MBP measured with 1): r = 0.29; p = 0.027, but not with 2): r = 0.24; ns, nor with 3): r = 0.26; ns. These results suggest that: 1-blood pressure of IDDs should be measured in standardized conditions; 2-diurnal ambulatory blood pressure recording does not predict incipient nephropathy in these subjects.
Arch Mal Coeur Vaiss 1992 Aug
PMID:[Comparison of 3 methods of measurement of blood pressure in insulin-dependent diabetic patients with or without incipient diabetic nephropathy]. 148 51

The purpose of the study was to evaluate the loss of nocturnal (N) decline in blood pressure (BP) in type II treated hypertensive diabetics. The study concerned 36 hypertensive diabetics 59 +/- 10 years old, 20 men and 16 women, with poor metabolic control (HbA1C: 9.6 +/- 3%), without dysautonomia; 14 had macroproteinuria and/or microalbuminuria (mu alb) (< 30 micrograms/min). An ambulatory BP monitoring (Spacelabs 90207) was performed in all patients. Left ventricular mass index (LVMI) and E/A were determined by Doppler-echocardiography. Two groups (G) were individualized: G1 (n = 17), with a normal circadian rhythm (diurnal and N.BP significantly different); G2 (n = 19) with a loss of N decline in systolic (S) and diastolic (D) BP or both; and compared to non diabetic treated hypertensive controls (G3). There was no difference neither in LVMI (125 +/- 43 g/m2), E/A (0.7), 24 h-mean (M) BP in the three groups, nor in HbA1C levels and mu alb occurrence in G1 and G2. Mean N.SBP and mean N.DBP were more closely related to LVMI in G2 than in G1 and G3. [table: see text] Half of these hypertensive diabetics, with bad metabolic control, have an altered circadian BP pattern; the prognostic value of nocturnal BP, related to LVMI despite the antihypertensive treatment, is suggested.
Arch Mal Coeur Vaiss 1992 Aug
PMID:[Value of nocturnal blood pressure in treated non-insulin-dependent hypertensive patients]. 148 52

The present study was designed to evaluate the frequency of an increase in the urinary albumin excretion rate (UAER) and the factors involved in this parameter in non-diabetic obese patients; 122 non-diabetic obese patients were investigated. None had proteinuria or history of nephropathy or uropathy. Fourty of them had moderate hypertension. Compared with a group of 22 lean controls, UAER was significantly higher in the obese patients (19.0 +/- 2.0 (SEM) mg/24 h vs 3.2 +/- 0.6 mg/24 h, p < 0.001). UAER was elevated (> 20 mg/24 h) in 29 patients (23.7%). Prevalence of microalbuminuria was not significantly different in hypertensive than in normotensive patients. However UAER was significantly higher in the 32 patients with a family history of hypertension (29.6 +/- 6.3 mg/24 h vs 15.3 +/- 1.5 mg/24 h, p < 0.002). In patients with microalbuminuria, body weight was significantly higher (100.3 +/- 3.9 kg vs 91.8 +/- 1.9 kg, p < 0.05), plasma albumin was significantly lower (38.3 +/- 0.6 g/l vs 40.3 +/- 0.3 g/l, p < 0.005) and the estimated value of fractional albumin clearance was significantly higher. These results show the high frequency of microalbuminuria in non-diabetic obese patients. They suggest that UAER level may be an index of family hypertension in obese patients and that microalbuminuria is part of a widespread abnormality of the capillary permeability.
Arch Mal Coeur Vaiss 1992 Aug
PMID:[Microalbuminuria and hypertension in obese patients]. 148 58

A high incidence of renal lesions is observed in patients with insulin-dependent diabetes. In the early stages of the disease glomerular capillary hemodynamics is altered with, in particular, glomerular hyperfiltration related to several factors: enhanced glomerular capillary flow rate, capillary hypertension and increased filtration area. These hemodynamic changes could affect development of the glomerular microangiopathy: the final outcome of this is the glomerulosclerosis associated with a progressively worsening and ineluctable chronic renal insufficiency. Hypertension, frequent in the early stages, is practically constant when the neuropathy stage has been reached; it is well established that hypertension accelerates the development of glomerular lesions and the progression of the renal impairment. Experimental and clinical studies have clearly demonstrated that antihypertensive treatment slows down the degradation of renal function. All antihypertensive drugs appear to be effective, but converting enzyme inhibitors, by their effects on renal hemodynamics, could play a particular role in the prophylactic treatment of diabetic nephropathy. Determination of urinary excretion of albumin (microalbuminuria), the global evidence of the onset of a nephropathy is useful for the follow up of the renal disease, allows follow up of the renal lesion and evaluation of the efficacy of treatment.
J Mal Vasc 1992
PMID:[Arterial hypertension and diabetic nephropathy]. 149 60

The mechanism of action of angiotensin converting enzyme (ACE) inhibitors on urinary albumin excretion (UAE) in diabetics is controversial. In order to dissociate the hypotensive and intrarenal effects, 16 insulin-dependant diabetics with permanent microalbuminuria (30-300 mg/24 h) without hypertension were given Ramipril, a long acting ACE inhibitor, at hypotensive (treatment A 5 mg/day; N = 8) and at sub-hypotensive doses (treatment B, 1.25 mg/day; N = 8) over a 6 week period in parallel double-blind study. Blood pressure, UAE, glomerular filtration renal blood flow (continuous 125I-Iodothalamate + 131I-Hippurate infusion) and converting enzyme activity (Liebermann's method), before and after treatment. In treatment group A, the blood pressure fell from 133 +/- 5/79 +/- 4 (mean +/- SE) to 125 +/- 4/77 +/- 2 mmHg (p less than 0.05 for systolic blood pressure) whereas it remained stable in treatment group B (132 +/- 7/79 +/- 4 to 128 +/- 5/80 +/- 4 mmHg). The UAE decreased in both groups: group A from an average of 74 (40-198) to 47 (5-202) mg/24 h (p = 0.07; group B, from an average of 77 (50-136) to 19 (15-120) mg/24 h (p less than 0.005), as did ACE activity: group A from 332 +/- 44 to 163 +/- 33 iu/l (p less than 0.004), group B from 423 +/- 39 to 191 +/- 28 iu/l (p less than 10-4).(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1991 Mar
PMID:[Dissociation of hypotensive and renal hemodynamic effects of an angiotensin converting enzyme inhibitor in insulin-dependent diabetic patients with incipient nephropathy]. 182 59

Microalbuminuria predicts increased rate of hypertension and mortality in insulino-dependent diabetics. In non insulin-dependent diabetes, hypertension often exists before onset of diabetes. To study effects of preexisting hypertension on prevalence and occurrence of elevated urinary albumin excretion (UAE), we collected datas from 614 non insulin-dependent diabetics, in a cross sectional survey: age was 60 +/- 10.4 years, (range 40-75 years), body mass index (BMI) 29 +/- 5.8 kg/m2, hemoglobin A1C 8 +/- 1.9%, systolic blood pressure (SBP) 134 +/- 18 mmHg, diastolic blood pressure (DBP) 76 +/- 10 mmHg, and serum creatinine 91 +/- 44 mumol/l. In the whole group, prevalence of hypertension was 59%. Microalbuminuria (EUA 20-200 mg/l) was present in 25.9% of the cases, microalbuminuria (EUA greater than 200 mg/l) in 7.5%. Cases with hypertension existing before or at onset of diabetes were 243 (HT group), cases without hypertension at onset were 371 (non HT group). In HT group, prevalence of microalbuminuria in increasing class of duration of diabetes were: 31% (0-4 years), 25% (5-9 years), 35% (10-14 years), 21% (15-19 years). Prevalence of macroalbuminuria was respectively: 3%, 11%, 15% and 4%. In the non HT group, microalbuminuria was present in 14% of the cases (0-4 years), 24% (5-9 years), 30% (10-14 years), 25% (15-19 years); prevalences of macroalbuminuria were: 1%, 8%, 6%, 15%. Mean values of UAE, compared to values of the class 0-2 years, were significantly higher in class 12-14 years (32.3 +/- 8 vs 14.4 +/- 3.7 mg/l; p = 0.02] in the HT group.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1991 Aug
PMID:[Effect of pre-existing hypertension on the prevalence and incidence of microalbuminuria in non insulin-dependent diabetic patients]. 195 56

Albumin excretion rate in urine is a marker of early, reversible stages of diabetic nephropathy. Does abnormal blood rheology represent an additional risk factor in this multifactorial process? We investigated a possible link between red cell filterability and microalbuminuria during an exercise test (exercise is supposed to improve the detection of excessive microalbuminuria). 77 diabetics (27 females, 50 males, age: 15-60 yr) underwent a 20 min inframaximal progressively increasing workload on cycloergometer, rising heart rate up to 200 minus the age. Filterability of whole blood and washed red cells were measured on 5 microns polycarbonate sieves reused after ultrasonic cleaning. Whole blood filterability was found to be impaired in 35 subjects (group A) and normal in 41 (group B). Groups A and B were matched for age, sex, blood pressure, glycemic equilibrium, and duration of disease. Microalbuminuria was higher in A at rest (39.79 +/- 13.83 micrograms/min vs 12.9 +/- 3.21, p less than 0.01) and after exercise (91.80 +/- 20.79 vs 42.23 +/- 7.85, p less than 0.01). The slopes of regression lines between resting Microalbuminuria and blood pressure were greater in group A than in group B (p less than 0.01). No relationship between microalbuminuria and washed red cell filterability was detected. This study confirms on a larger scale a previous report of our team. Some hemorheologic disorders detectable with whole blood filterability (but not with washed red cell filtration) are associated with an increase in resting and postexercise microalbuminuria.
J Mal Vasc 1991
PMID:Increased albumin excretion rate during a standardized exercise-test in diabetics with lowered blood filterability. 201 Jul 5

We studied the effect of perindopril, administered during 9 months on the renal function, albuminuria and glycaemic control of diabetic subjects with a mild to moderate hypertension. After 1 month placebo, 40 insulin-treated patients were divided in 3 groups based upon the level of albuminuria. Group I had a normoalbuminuria (less than 15 mg/24 hrs). group II had a pathological microalbuminuria (15-150 mg/24 hrs) and group III had a macroproteinuria (greater than 150 mg/24 hrs). They were given perindopril (4 or 8 mg) once daily. Diastolic blood pressure was normalized within the first 3 months in 80 p. 100 of the patients. From these, 29 (13, 9 and 7 from groups I, II and III, respectively) were followed during a total treatment period of 9 months. They were matched for age, durations of diabetes and hypertension, daily insulin dose, systolic and diastolic blood pressures and quality of glycaemic control. Diastolic blood pressure was decreased by 14 and 17 p. 100 at 1 and 9 months, respectively. Heart rate was not significantly modified. At 3 months, the activity of angiotensin-converting enzyme was markedly inhibited while plasma renin activity was increased. In patients of group II, microalbuminuria was reduced from 59 +/- 13 to 32 +/- 6 mg/24 hrs after 1 month and this effect was maintained at 9 months. Despite similar decreases in blood pressure, no significant change of the albuminuria excretion rate was observed in patients of group I or III, respectively. Creatinine clearance remained stable and glycaemic control did not change throughout the study in the 3 groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1989 May
PMID:Renal function, glycaemic control and perindopril in diabetic patients. 250 14


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