220 results on '"H. H. Parving"'
Search Results
102. The impact of hypertension and antihypertensive treatment on the course and prognosis of diabetic nephropathy
- Author
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H H, Parving
- Subjects
Diabetes Mellitus, Type 1 ,Hypertension ,Humans ,Diabetic Nephropathies ,Prognosis ,Antihypertensive Agents ,United States - Abstract
The primary cause of arterial hypertension and of the increased morbidity and mortality in patients with insulin-dependent diabetes mellitus (IDDM) is diabetic nephropathy. About 35% of IDDM patients develop persistent albuminuria, an irreversible decline in the glomerular filtration rate and elevated blood pressure, which collectively contribute to the clinical syndrome of diabetic nephropathy. The excess mortality of IDDM patients with nephropathy is 80-100 times greater than that of an age- and sex-matched non-diabetic population. Diabetic nephropathy is the single most important cause of end-stage renal disease in the Western world, accounting for over a quarter of all such cases. Blood pressure elevation is a frequent finding, even in the early stages of diabetic nephropathy. Elevated blood pressure accelerates diabetic nephropathy, while an effective blood pressure reduction delays the progression of nephropathy and reduces albuminuria. A reduction in glomerular capillary hydraulic pressure may be the crucial factor. All previous reports dealing with the natural history of diabetic nephropathy have demonstrated a cumulative death rate of between 50% and 77% 10 years after the onset of nephropathy. Effective antihypertensive treatment has reduced this rate to 15-20%.
- Published
- 1990
103. A nation-wide cross-sectional study of urinary albumin excretion rate, arterial blood pressure and blood glucose control in Danish children with type 1 diabetes mellitus. Danish Study Group of Diabetes in Childhood
- Author
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H B, Mortensen, K, Marinelli, K, Nørgaard, K, Main, K W, Kastrup, K K, Ibsen, J, Villumsen, and H H, Parving
- Subjects
Blood Glucose ,Male ,Diabetes Mellitus, Type 1 ,Adolescent ,Reference Values ,Denmark ,Albuminuria ,Humans ,Mass Screening ,Blood Pressure ,Diabetic Nephropathies ,Female ,Child - Abstract
Nation-wide screening for microalbuminuria in Denmark was performed in 22 paediatric departments treating children with Type 1 diabetes. Over a period of 6 months 1020 children (less than or equal to 12 years) and adolescents (greater than 12 to 19 years) were screened (81% of total). Of these, 957 (94%) performed at least two timed overnight urine collections. In 209 non-diabetic subjects the upper 95% limit for normal albumin excretion rate (AER) was 20 micrograms min-1. Mean overnight AER was significantly (p less than 0.001) elevated in diabetic (3.0 x/divided by 2.3 (SD tolerance factor) micrograms min-1) and in non-diabetic (2.5 x/divided by 2.2 micrograms min-1) adolescents compared with diabetic (1.7 x/divided by 2.1 micrograms min-1) and non-diabetic (1.3 x/divided by 2.2 micrograms min-1) children. In the diabetic patients AER was positively correlated with the body surface area and age. Among the patients with Type 1 diabetes, 4.3% (18 males and 23 females) had AER greater than 20 to 150 micrograms min-1 (persistent microalbuminuria). A further 7 adolescents (0.7%) had overt proteinuria (greater than 150 micrograms min-1). Clinical data for the 41 diabetic patients with AER greater than 20 to 150 micrograms min-1 were compared with those for 569 diabetic adolescents with AER less than or equal to 20 micrograms min-1 and duration of diabetes more than 2 years. The group with AER greater than 20 to 150 micrograms min-1 had significantly higher mean age (16.5 years) than the group with AER less than or equal to 20 micrograms min-1 (15.0 years; p less than 0.001). Females with AER greater than 20 to 150 micrograms min-1 had significantly higher mean HbA1c level (10.8 +/- 1.9%) than those with AER less than or equal to 20 micrograms min-1 (9.8 +/- 1.9%, p less than 0.003); they also had impaired linear growth (standard deviation score -0.25 vs + 0.16; p = 0.003). These associations were not found in males. Mean body mass index (BMI) was significantly increased in both females (22.2 +/- 2.9 kg m-2) and males (20.8 +/- 2.7 kg m-2) with AER greater than 20 to 150 micrograms min-1, compared with diabetic patients with AER less than or equal to 20 micrograms min-1 (females 20.8 +/- 3.0 kg m-2, p = 0.02; males 19.7 +/- 2.4 kg m-2, p less than 0.006).(ABSTRACT TRUNCATED AT 400 WORDS)
- Published
- 1990
104. A comparative study of microvascular complications in patients with secondary and type 1 diabetes
- Author
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E. K. Philipsen, H. Lund-Andersen, H.-H. Parving, S.E. Larsen, Jannik Hilsted, and H. Worning
- Subjects
Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Blood Pressure ,Gastroenterology ,Vibration perception ,Endocrinology ,Diabetic Neuropathies ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,Diabetes Mellitus ,Medicine ,Albuminuria ,Humans ,Type 1 diabetes ,Diabetic Retinopathy ,business.industry ,Middle Aged ,medicine.disease ,Surgery ,Diabetes Mellitus, Type 1 ,Pancreatitis ,Chronic Disease ,Microalbuminuria ,Female ,medicine.symptom ,business ,Complication ,Diabetic Angiopathies ,Retinopathy - Abstract
The prevalence of retinopathy, albuminuria, and neuropathy were assessed in 25 patients with insulin-requiring diabetes secondary to chronic pancreatitis and in 25 patients with Type 1 (insulin-dependent) diabetes, matched for age at diabetes onset (secondary, 39 +/- 11 (+/- SD) years vs Type 1, 38 +/- 11 years) and duration of diabetes (10 +/- 6 vs 10 +/- 7 years). The prevalence of retinopathy was significantly higher in Type 1 diabetic patients (52%) than those with secondary diabetes (20%) (p less than 0.02). Median urinary excretion of albumin was 9 (range 1-206) mg 24-h-1 in patients with Type 1 diabetes and 7 (1-90) mg 24-h-1 in patients with secondary diabetes (NS). One secondary diabetic patient and five Type 1 diabetic patients had microalbuminuria (NS). Vibration perception threshold (measured at the big toe) was identical in the two groups of patients, and no patient had a threshold indicating somatic neuropathy (biothesiometry greater than 20 V). Retinopathy is more frequent in patients with Type 1 diabetes than in patients with insulin-requiring diabetes secondary to chronic pancreatitis. Retinopathy is so frequent in the latter group, however, that regular ophthalmoscopic examination is still required.
- Published
- 1990
105. Protective effect of captopril on the blood-retina barrier in normotensive insulin-dependent diabetic patients with nephropathy and background retinopathy
- Author
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Henrik Lund-Andersen, H H Parving, Michael Larsen, and E Hommel
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,Captopril ,Blood–retinal barrier ,Blood Pressure ,Permeability ,Nephropathy ,Cellular and Molecular Neuroscience ,Diabetes mellitus ,Internal medicine ,Blood-Retinal Barrier ,medicine ,Humans ,Diabetic Nephropathies ,Prospective Studies ,Prospective cohort study ,Diabetic Retinopathy ,biology ,business.industry ,Hemoglobin C ,Angiotensin-converting enzyme ,medicine.disease ,Fluoresceins ,Sensory Systems ,Ophthalmology ,Blood pressure ,Endocrinology ,medicine.anatomical_structure ,Diabetes Mellitus, Type 1 ,biology.protein ,Female ,Fluorescein ,business ,medicine.drug ,Retinopathy - Abstract
The effect of 18 months' inhibition of angiotensin-converting enzyme by captopril on the leakage of fluorescein through the blood-retina barrier was examined in a prospective, randomized control study of 20 normotensive insulin-dependent diabetic patients with nephropathy and background retinopathy. After 18 months, 15 patients remained in the study. Fluorescein leakage remained nearly unchanged in the captopril-treated group, being 4.1 +/- 4.1 (mean +/- SD) x 10(-7) cm/s at baseline and 4.2 +/- 4.1 x 10(-7) cm/s after 18 months' treatment. The permeability increased significantly (P less than 0.01) from 3.3 +/- 2.2 x 10(-7) cm/s to 5.6 +/- 3.5 x 10(-7) cm/s at 18 months in the control group. Arterial blood pressure was nearly constant in both groups throughout the study. The results indicate that angiotensin-converting enzyme inhibition with captopril can arrest or delay a progressive breakdown of the blood-retina barrier in normotensive insulin-dependent diabetic patients with nephropathy and background retinopathy.
- Published
- 1990
106. PO22-724 IMPACT OF METFORMIN VERSUS REPAGLINIDE ON POSTPRANDIAL GLYCAEMIA AND PLASMA LIPOPROTEINS IN NON-OBESE PATIENTS WITH TYPE-2 DIABETES MELLITUS (T2DM)
- Author
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Lise Tarnow, Søren S Lund, Ulla M Smidt, M. Frandsen, H.-H. Parving, Allan Vaag, and Oluf Pedersen
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Plasma lipoprotein ,medicine.medical_specialty ,business.industry ,Type 2 Diabetes Mellitus ,General Medicine ,Repaglinide ,Metformin ,Endocrinology ,Postprandial ,Non obese ,Internal medicine ,Internal Medicine ,medicine ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Published
- 2007
107. Tu-W19:4 Impact of metformin versus repaglinide on glycemic regulation and non-glycemic cardiovascular risk-markers in non-obese patients with type-2 diabetes
- Author
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C. Schalkwijk, Allan Vaag, H.-H. Parving, Søren S Lund, J. Gram, O. Pedersen, G. Poulsen, L. Tarnow, Coen D.A. Stehouwer, and Ulla M Smidt
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medicine.medical_specialty ,business.industry ,General Medicine ,Type 2 diabetes ,medicine.disease ,Repaglinide ,Gastroenterology ,Metformin ,Non obese ,Internal medicine ,Internal Medicine ,medicine ,Cardiology and Cardiovascular Medicine ,business ,Glycemic ,medicine.drug - Published
- 2006
108. Cholesterol-lowering therapy may retard the progression of diabetic nephropathy
- Author
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H. -H. Parving and K. S. L. Lam
- Subjects
Endocrinology, Diabetes and Metabolism ,Internal Medicine - Published
- 1996
109. Efectos de losartán sobre la evolución renal y cardiovascular en pacientes con diabetes tipo 2 y nefropatía
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Mark E. Cooper, William E. Mitch, H. H. Parving, Dick de Zeeuw, William F. Keane, and Barry M. Brenner
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Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2001
110. Design of clinical trials in proteinuria and progressive renal disease
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H.-H. Parving
- Subjects
medicine.medical_specialty ,Proteinuria ,business.industry ,Endocrinology, Diabetes and Metabolism ,Disease ,medicine.disease ,Clinical trial ,Endocrinology ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,medicine.symptom ,business - Published
- 1992
111. Excess mortality associated with diuretic therapy in diabetes mellitus
- Author
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H. H. Parving
- Subjects
Internal Medicine - Published
- 1992
112. Diabetes and end stage renal disease
- Author
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H.-H. Parving
- Subjects
medicine.medical_specialty ,Proteinuria ,business.industry ,Urinary system ,Urology ,Renal function ,medicine.disease ,End stage renal disease ,Diabetic nephropathy ,Diabetes mellitus ,Internal Medicine ,Albuminuria ,medicine ,Microalbuminuria ,medicine.symptom ,Intensive care medicine ,business - Published
- 2000
113. Author's reply
- Author
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H.-H. Parving
- Subjects
General Engineering ,General Earth and Planetary Sciences ,General Medicine ,General Environmental Science - Published
- 1996
114. Left ventricular hypertrophy in normoalbuminuric type 2 diabetic patients not taking antihypertensive treatment.
- Author
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H.-H. Parving
- Published
- 2005
115. Poor prognosis in proteinuric type 2 diabetic patients with retinopathy: insights from the RENAAL study.
- Author
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H.-H. Parving, C.E. Mogensen, M.C. Thomas, B.M. Brenner, and M.E. Cooper
- Published
- 2005
116. The increased proximal tubular reabsorption of sodium and water is maintained in long-term insulin-dependent diabetics with early nephropathy
- Author
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N. E. Bruun, Elisabeth R. Mathiesen, Eva Hommel, M. A. Gall, H.-H. Parving, and P Skøtt
- Subjects
Adult ,Male ,medicine.medical_specialty ,Lithium (medication) ,Sodium ,Clinical Biochemistry ,chemistry.chemical_element ,Renal function ,Nephropathy ,Kidney Tubules, Proximal ,Diabetic nephropathy ,Body Water ,Diabetes mellitus ,Internal medicine ,medicine ,Albuminuria ,Humans ,Diabetic Nephropathies ,General Medicine ,medicine.disease ,Diabetes Mellitus, Type 1 ,Endocrinology ,chemistry ,Renal physiology ,Female ,Microalbuminuria ,Glomerular Filtration Rate ,medicine.drug - Abstract
Proximal tubular reabsorption of sodium and water was investigated in long-term insulin-dependent diabetic patients with normoalbuminuria (group I, n = 19), microalbuminuria (group II, n = 39), diabetic nephropathy (group III, n = 12) and in 13 healthy age-matched subjects. Glomerular filtration rate was measured with the single injection, 51Cr-EDTA technique. The fluid flow rate out of the proximal tubules was assessed by the renal lithium clearance. Although glomerular filtration rate was significantly elevated in the diabetic patients (Group I: 122 +/- 16, Group II: 121 +/- 18, Group III: 110 +/- 17, CONTROLS: 105 +/- 13 ml/min X 1.73 m2), lithium clearance was similar in the four groups (Group I: 19 +/- 6, Group II: 22 +/- 7, Group III: 19 +/- 5, CONTROLS: 23 +/- 4 ml/min X 1.73 m2). Both absolute and fractional proximal reabsorption of sodium and water was enhanced in diabetes. Indices of distal tubular function did not differ between controls and patients with insulin-dependent diabetes. Sodium clearance was about the same in the four groups. Our study suggests that the enhanced proximal reabsorption of sodium and water in insulin-dependent diabetic patients is still observed despite the presence of incipient or overt diabetic nephropathy.
- Published
- 1989
117. Prevalence and causes of microscopic haematuria in Type 1 (insulin-dependent) diabetic patients with persistent proteinuria
- Author
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H. Carstensen, Peter Skøtt, Svend Larsen, H.-H. Parving, and Eva Hommel
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Biopsy ,Endocrinology, Diabetes and Metabolism ,urologic and male genital diseases ,Gastroenterology ,Nephropathy ,Diabetic nephropathy ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Humans ,Outpatient clinic ,Diabetic Nephropathies ,Hematuria ,Type 1 diabetes ,Diabetic Retinopathy ,Proteinuria ,business.industry ,Middle Aged ,medicine.disease ,female genital diseases and pregnancy complications ,Glomerular Mesangium ,Surgery ,Diabetes Mellitus, Type 1 ,Albuminuria ,Female ,medicine.symptom ,business ,Retinopathy - Abstract
The prevalence and causes of microscopic haematuria were examined in all Type 1 (insulin-dependent) diabetic patients with persistent proteinuria (diabetes duration greater than or equal to 5 years) attending the outpatient clinic at Hvidöre Hospital during 1985. One hundred eighty-four patients (69F/115M) out of 1024 Type 1 patients had persistent proteinuria (18%). Microscopic haematuria was defined as greater than or equal to 3 erythrocytes per high power field in two or more sterile urine samples. Twenty-three Type 1 patients with persistent proteinuria (7F/16M, aged 35.4 +/- 13 years) had microscopic haematuria (12.5%). No significant changes were found between the group with and without microscopic haematuria: blood pressure 148/89 +/- 22/11 versus 145/91 +/- 20/11 mmHg, duration of diabetes when persistent albuminuria occurred 17 +/- 8 versus 20 +/- 10 years, serum creatinine 99 +/- 24 versus 98 +/- 31 mumol/l, simplex retinopathy 61 versus 54%, proliferative retinopathy 39 versus 42%, and no signs of retinopathy 0 versus 4%. Kidney biopsy was performed in 13 out of the 23 patients with microscopic haematuria. Diabetic glomerulosclerosis was present in all 13 patients, but 9 patients had a non-diabetic renal disease superimposed (mesangioproliferative glomerulonephritis (n = 5), membranous glomerulonephritis (n = 3) and sarcoidosis (n = 1). Microscopic haematuria is a rare finding, frequently reflecting superimposed non-diabetic glomerulopathies, in Type 1 diabetic patients with diabetic nephropathy and well preserved kidney function.
- Published
- 1987
118. The effect of metabolic control on hemodynamics in short-term insulin-dependent diabetic patients
- Author
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E. R. Mathiesen, J. Hilsted, B. Feldt-Rasmussen, F. Bonde-Petersen, N. J. Christensen, and H. H. Parving
- Subjects
Endocrinology, Diabetes and Metabolism ,Internal Medicine - Published
- 1985
119. Prognosis in diabetic nephropathy
- Author
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H. H. Parving and E. Hommel
- Subjects
Adult ,Male ,medicine.medical_specialty ,Letter ,Blood Pressure ,Nephropathy ,Diabetic nephropathy ,Median follow-up ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Diabetic Nephropathies ,Prospective Studies ,Prospective cohort study ,Antihypertensive Agents ,General Environmental Science ,Cause of death ,business.industry ,Mortality rate ,General Engineering ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Surgery ,Diabetes Mellitus, Type 1 ,Blood pressure ,General Earth and Planetary Sciences ,Female ,business ,Research Article ,Follow-Up Studies - Abstract
OBJECTIVE--To assess the effect of long term antihypertensive treatment on prognosis in diabetic nephropathy. DESIGN--Prospective study of all insulin dependent diabetic patients aged under 50 with onset of diabetes before the age of 31 who developed diabetic nephropathy between 1974 and 1978 at Steno Memorial Hospital. SETTING--Outpatient diabetic clinic in tertiary referral centre. PATIENTS--Forty five patients (20 women) with a mean age of 30 (SD 7) years and a mean duration of diabetes of 18 (7) years at onset of persistent proteinuria were followed until death or for at least 10 years. INTERVENTIONS--Antihypertensive treatment was started a median of three (0-13) years after onset of nephropathy. Four patients (9%) received no treatment, and 9 (20%), 13 (29%), and 19 (42%) were treated with one, two, or three drugs, respectively. The median follow up was 12 (4-15) years. MAIN OUTCOME MEASURES--Arterial blood pressure and death. RESULTS--Mean blood pressure at start of antihypertensive treatment was 148/95 (15/50) mm Hg. Systolic blood pressure remained almost unchanged (slope -0.01 (95% confidence interval -0.39 to 0.37) mm Hg a year) while diastolic blood pressure decreased significantly (0.87 (0.65 to 1.10) mm Hg a year) during antihypertensive treatment. The cumulative death rate was 18% (8 to 32%) 10 years after onset of nephropathy, in contrast to previous reports of 50% to 77% 10 years after onset of nephropathy. As in previous studies, uraemia was the main cause of death (9 patients; 64%). CONCLUSIONS--The prognosis of diabetic nephropathy has improved during the past decade largely because of effective antihypertensive treatment.
- Published
- 1989
120. Reduced Urinary Excretion of Epidermal Growth Factor in Incipient and Overt Diabetic Nephropathy
- Author
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H. H. Parving, Eva Hommel, E. Nexø, and Elisabeth R. Mathiesen
- Subjects
Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Renal function ,Nephron ,Nephropathy ,Diabetic nephropathy ,Excretion ,Endocrinology ,Reference Values ,Epidermal growth factor ,Internal medicine ,Internal Medicine ,medicine ,Albuminuria ,Humans ,Diabetic Nephropathies ,Epidermal Growth Factor ,business.industry ,Albumin ,medicine.disease ,Diabetes Mellitus, Type 1 ,medicine.anatomical_structure ,Female ,Microalbuminuria ,business ,Biomarkers ,Glomerular Filtration Rate - Abstract
To study the relationship between glomerular and tubular function we investigated glomerular filtration rate (GFR), urinary albumin excretion, and urinary excretion of epidermal growth factor (EGF, a mitogenic peptide synthesized in the renal tubular cells) in normal subjects (group I, n = 7) and in Type 1 (insulin-dependent) diabetic patients with normoalbuminuria (group II, n = 11); with incipient nephropathy (microalbuminuria) (group III, n = 9); with nephropathy and normal GFR (group IV, n = 12); and with reduced GFR (group V, n = 8). EGF (nmol 24 h-1) decreased with progressive glomerular involvement, from 7.9 (4.1-10.5) (median and range) in group I, to 6.7 (1.3-9.2) in group II, 5.0 (3.6-7.4) in group III, 4.1 (2.5-9.5) in group IV, and 1.1 (0.1-2.5) in group V. The urinary excretion of EGF was significantly reduced in patients with elevated UAE (group III, IV, and V) compared with normal control subjects (p less than 0.05). A significant correlation between urinary excretion of EGF and GFR (r = 0.71, p less than 0.001) and an inverse correlation between the urinary excretion of EGF and albumin (r = -0.35, p less than 0.05) was demonstrated in the Type 1 diabetic patients with GFR greater than 90 ml min-1. Our study demonstrates that urinary excretion of epidermal growth factor diminishes with increasing nephron impairment, and that renal tubular function as judged by the excretion of EGF is reduced early in the development of diabetic kidney disease.
- Published
- 1989
121. Increased minimal vascular resistance and arteriolar hyalinosis in skin on the leg in insulin-dependent diabetic patients
- Author
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J. Kastrup, T. Nørgaard, H. -H. Parving, and N. A. Lassen
- Subjects
Clinical Biochemistry ,General Medicine - Published
- 1987
122. Filtration as the main mechanism of overall transcapillary protein escape from the plasma
- Author
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H.-H. Parving, Niels A. Lassen, and N. Rossing
- Subjects
law ,Chemistry ,Biophysics ,Cell Biology ,Cardiology and Cardiovascular Medicine ,Biochemistry ,Filtration ,Mechanism (sociology) ,law.invention - Published
- 1974
123. Extracellular fluid volume determined by a single injection of inulin in men with untreated essential hypertension
- Author
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H H Parving, H. Æ. Jensen, and H. Lönsmann Poulsen
- Subjects
Adult ,Male ,medicine.medical_specialty ,Clinical Biochemistry ,Inulin ,Urology ,Blood Pressure ,Plasma volume ,Essential hypertension ,chemistry.chemical_compound ,Extracellular fluid ,medicine ,Humans ,Plasma Volume ,Serum Albumin ,General Medicine ,Single injection ,Middle Aged ,medicine.disease ,Normal group ,Surgery ,Blood pressure ,Hematocrit ,chemistry ,Interstitial volume ,Hypertension ,Extracellular Space - Abstract
The extracellular volume (ECV) and plasma volume (PV) were determined simultaneously in nine men with untreated essential hypertension and in nine healthy matched control subjects, using a single injection of inulin and of 131I-labelled human serum albumin, respectively. The average mean arterial blood pressure in the hypertensive group was 178/118 mmHg. ECV was nearly the same in the two groups, viz. 151 ml/kg body weight (SD 17) in the hypertensive group compared to 147 ml/kg (SD 16) in the control group. The corresponding figures for PV were 38.2 ml/kg body weight (SD 4.7) and 43.7 ml/kg (SD 7.9) respectively (P less than 0.1). The calculated interstitial fluid volume (IV) was 113 ml/kg (SD 16) and 103 ml/kg (SD 10) (P less than 0.2). The PV/IV ratio was significantly lower (P less than 0.02) in the hypertensive group (0.34, SD 0.06) than in the normal group (0.42, SD 0.06). The difference might suggest increased transcapillary water filtration in hypertension.
- Published
- 1977
124. Clinical Physiology: Increased Metabolic Turnover Rate and Transcapillary Escape Rate of Albumin in Long-Term Juvenile Diabetics
- Author
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H. -H. Parving, N. Rossing, and E. Sander
- Subjects
Clinical Biochemistry ,General Medicine - Published
- 1975
125. Kidney function and size in diabetics before and during initial insulin treatment
- Author
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Per Aaby Svendsen, H H Parving, Jens Sandahl Christiansen, Bente Tronier, and Jens Gammelgaard
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Renal function ,Newly diagnosed ,Kidney ,urologic and male genital diseases ,Positive correlation ,Renal Circulation ,Internal medicine ,Diabetes Mellitus ,medicine ,Humans ,Insulin ,urogenital system ,business.industry ,Organ Size ,female genital diseases and pregnancy complications ,Endocrinology ,medicine.anatomical_structure ,Nephrology ,Metabolic control analysis ,Renal blood flow ,Female ,business ,Glomerular Filtration Rate - Abstract
GFR, RPF, and kidney size were measured in nine young recently diagnosed insulin-dependent diabetics before (days 0) and 3 and 8 days after the beginning of the initial insulin treatment and in comparable control subjects. Kidney function was measured by a constant infusion technique using I-125-iothalamate and 131-I-hippuran. Kidney size was determined by means of ultrasound. Before insulin treatment elevated values for GFR (+44%, P less than 0.01), RPF (+18%, P less than 0.05), and kidney size (+29%, P less than 0.01) were found. Near-normal metabolic control was achieved in all patients using either multiple subcutaneous injections of insulin or an artificial betacell. GFR decreased from 160 +/- 9 SEM to 141 +/- 6 ml/min X 1.73 m2 (P less than 0.01) and further to 133 +/- 5 ml/min X 1.73 m2 (P less than 0.01, compared to day 0). Renal plasma flow was 601 +/- 33 and 588 +/- 44 ml x 1.73 m2 at days 0 and 3, respectively (NS) and decreased to 558 +/- 35 ml/min x 1.73 m2 at day 0 (P less than 0.01). By contrast no statistically significant changes in kidney volume were observed; the results on day 0, 3 and 8 were 145 +/- 7, 162 +/- 11 and 143 +/- 9 ml/1.73 m2, respectively. The present study demonstrates that kidney size and function are elevated at the onset of insulin-dependent diabetes. Near-normal metabolic control; for 8 days induces a reduction but not a complete normalization in kidney function. From the present observations it is suggested that the rapidly reversible part of the elevation in GFR cannot be explained by concomitant changes in kidney and glomerular size (morphological origin) but is probably due to a reduction in renal plasma flow and to a decreased transglomerular pressure (functional origin).
- Published
- 1982
126. Prevalence of microalbuminuria in children with Type 1 (insulin-dependent) diabetes mellitus
- Author
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H. H. Parving, Elisabeth R. Mathiesen, N. Saurbrey, and Eva Hommel
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Urine ,Gastroenterology ,Urine collection device ,Diabetic nephropathy ,Excretion ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Albuminuria ,Humans ,Diabetic Nephropathies ,Child ,Type 1 diabetes ,business.industry ,medicine.disease ,Diabetes Mellitus, Type 1 ,Blood pressure ,Endocrinology ,Female ,Microalbuminuria ,business - Abstract
The prevalence of microalbuminuria was determined in children aged 7 to 18 years with Type 1 (insulin-dependent) diabetes of more than 2 years' duration. All patients (n = 102) attending 2 diabetes clinics were asked to collect 2 overnight timed urine samples for albumin analysis by radioimmunoassay. Complete urine collection was obtained in 97 patients (95%). Overnight urinary albumin excretion rates were also measured in 36 healthy children matched for age and sex. Nineteen of the 97 patients (20%) had microalbuminuria, i.e. overnight urinary albumin excretion rates above the upper normal level (14 micrograms/min) in both urine collections. Microalbuminuria was only demonstrated in patients aged greater than or equal to 15 years, prevalence 37% (19/52 patients). Arterial blood pressure was elevated, mean 122/84 +/- 11/9mmHg, in the microalbuminuric group (19 patients) compared to the age-matched normoalbuminuric diabetic group (33 patients), mean 117/74 +/- 10/10mm Hg, p less than 0.001. The prevalence of simplex retinopathy was identical in these two groups, i.e. 25%. Glycosylated haemoglobin was slightly higher in the microalbuminuric patients, p less than 0.10. Our cross-sectional study reveals a high prevalence (37%) of persistent microalbuminuria, a stage highly predictive of later development of diabetic nephropathy, in Type 1 diabetic children aged greater than or equal to 15 years.
- Published
- 1986
127. Loss of Autoregulation of Blood Flow in Subcutaneous Tissue in Juvenile Diabetes
- Author
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H H Parving, N A Lassen, O. Henriksen, and J. Kastrup
- Subjects
Adult ,Male ,medicine.medical_specialty ,Blood Pressure ,Diabetic nephropathy ,Internal medicine ,Diabetes mellitus ,medicine ,Homeostasis ,Humans ,Autoregulation ,Skin ,Pharmacology ,business.industry ,Blood flow ,medicine.disease ,Diabetes Mellitus, Type 1 ,Blood pressure ,medicine.anatomical_structure ,Regional Blood Flow ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Retinopathy ,Subcutaneous tissue - Abstract
The autoregulation of blood flow in subcutaneous tissue was investigated at the level of the lateral malleolus by the local 133Xenon washout technique. We have investigated eight long-term insulin-dependent diabetics and seven healthy controls. All diabetics had moderate diabetic nephropathy and retinopathy. The blood flow remained constant in all normal subjects, when the arterial perfusion pressure was varied between 70 and 150 mm Hg. All diabetics had impaired or reduced autoregulation of the subcutaneous blood flow. The blood flow increased and decreased almost linearly with the changes in arterial perfusion pressure. The mechanism underlying the defect autoregulation of blood flow in diabetics is uncertain; possibilities include structural changes of the arterioles and/or alterations of local metabolic factors.
- Published
- 1984
128. Elevated Urinary Prostaglandin Excretion and the Effect of Indomethacin on Renal Function in Incipient Diabetic Nephropathy
- Author
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H. H. Parving, U. B. Olsen, Elisabeth R. Mathiesen, and Eva Hommel
- Subjects
Adult ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Urinary system ,Indomethacin ,Renal function ,Kidney ,Dinoprostone ,Nephropathy ,Excretion ,Endocrinology ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Albuminuria ,Humans ,Diabetic Nephropathies ,business.industry ,Prostaglandins E ,Middle Aged ,medicine.disease ,Diabetes Mellitus, Type 1 ,Prostaglandins ,Female ,Microalbuminuria ,medicine.symptom ,business ,Glomerular Filtration Rate ,Kidney disease - Abstract
We investigated whether the glomerular synthesis of prostaglandins modulates the glomerular filtration rate and urinary albumin excretion in incipient diabetic nephropathy (defined as urinary albumin excretion between 30 and 300 mg/24 h (microalbuminuria) in two out of three sterile ketone-free 24-h urine collections in patients having insulin-dependent diabetes mellitus (IDDM) without hypertension or other kidney disease). The urinary excretion of prostaglandin E2 was significantly elevated in 8 insulin-dependent diabetic patients with incipient nephropathy as compared with 9 normoalbuminuric IDDM patients and 11 healthy controls: 317 (182-1273); 95 (67-225); 132 (54-263) pg/min, respectively (2p less than 0.01). Glomerular filtration rate (single bolus 51Cr-EDTA technique) and albuminuria (radioimmunoassay) were measured twice within 2 weeks in 8 females having IDDM with incipient nephropathy. The study design was a randomized double-blind trial with the patients receiving either indomethacin (150 mg/day) or placebo for 3 days prior to the kidney function studies. Indomethacin treatment induced a significant reduction in urinary prostaglandin E2 excretion (73%) (2p less than 0.01), urinary albumin excretion rate diminished from 207 (63-253) to 87 (49-147) mg/24 h (2p less than 0.01), fractional clearance of albumin declined (70%) (2p less than 0.01). Glomerular filtration rate remained stable (108 (88-133) versus 110 (95-142) ml/min). Blood glucose and blood pressure were comparable during the placebo and indomethacin treatment (12.6 +/- 3 versus 13.4 +/- 5 mmol/l and 122/79 +/- 3/9 versus 122/82 +/- 4/10 mmHg, respectively). Our results suggest that enhanced glomerular synthesis of vasodilating prostaglandins may accelerate microalbuminuria in incipient diabetic nephropathy.
- Published
- 1988
129. Transcapillary escape rate of albumin and right atrial pressure in chronic congestive heart failure before and after treatment
- Author
-
B Hesse, I Noer, H Lund-Jacobsen, and H H Parving
- Subjects
Adult ,Male ,medicine.medical_specialty ,Chronic congestive heart failure ,Physiology ,Sodium ,chemistry.chemical_element ,Albumins ,Internal medicine ,Pressure ,medicine ,Humans ,Escape rate ,Heart Atria ,Diuretics ,Heart Failure ,Albumin ,Central venous pressure ,Heart ,Middle Aged ,medicine.disease ,Human serum albumin ,Capillaries ,Surgery ,chemistry ,Heart failure ,Chronic Disease ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,After treatment ,medicine.drug - Abstract
The transcapillary escape rate of albumin (TERalb), i.e., the fraction of intravascular mass of albumin that passes to the extravascular space per unit of time, was determined from the disappearance of intravenously injected 125I-labeled human serum albumin during the first 60 minutes after injection in 10 subjects with chronic right heart failure. The investigation was repeated after sodium and water depletion. Before treatment TERalb was significantly elevated (mean 8.3 +/- 1.6% (SD)/hour, in comparison to values for normal subjects (mean 5.4 +/- 1.1%/hour, P less than 0.001). With treatment TERalb decreased significantly (mean 5.9 +/- 1.2%/hour, P less than 0.01). Right atrial pressure decreased from an average of 10 mm Hg to 6 mm Hg during treatment. A statistically significant, positive correlation was found between TERalb and right atrial pressure (r = 0.77, P less than 0.001). Our results best can be explained by increased filtration, mainly through the venous end of the microvasculature, due to the increased venous pressure in heart failure.
- Published
- 1976
130. Increased transcapillary escape rate of albumin and IgG in essential hypertension
- Author
-
Jensen Ha, Westrup M, and H.-H. Parving
- Subjects
Adult ,Male ,medicine.medical_specialty ,Clinical Biochemistry ,Blood Pressure ,Vascular permeability ,Normal values ,Essential hypertension ,Capillary Permeability ,Internal medicine ,medicine ,Humans ,Escape rate ,Serum Albumin ,Chemistry ,Albumin ,Human albumin ,General Medicine ,Middle Aged ,medicine.disease ,Endocrinology ,Blood pressure ,Immunoglobulin G ,Hypertension ,Injections, Intravenous ,Immunology ,Significant positive correlation - Abstract
Transcapillary escape rates of albumin and IgG (fractions of intravascular mass of albumin and IgG that pass to the extravascular space per unit time) were determined simultaneously from the initial disappearance of intravenously injected 131I human albumin and 125I human IgG in seven untreated subjects suffering from essential hypertension. The average mean arterial blood pressure of these subjects 193/119 mmHg; four subjects had grade I-III funduscopic changes. Transcapillary escape rates of albumin (TERalb) and IgG (TERIgG) were found significantly increased in the hypertensive subjects, average 7.8 +/- 0.9 (SD) and 4.7 +/- 1.0 (SD) %/h, respectively, compared with normal values of mean 5.2 +/- 1.0 (SD) and 3.0 +/- 0.7 (SD) %/h, respectively (P less than 0.01). There was a statistically significant positive correlation between the mean arterial blood pressure and TER of albumin and of IgG (P less than 0.001). The TERIgG/TERalb ratio was about the same in the hypertensives and the normals. Confirming a previous observation, we found an increase in the daily urinary albumin excretion rate from a normal average of 9.1 (range, 2.4-20.4)mg/24 h to 96 (range, 5.6-565) mg/24 h, P less than 0.05. The present findings can best be explained by increased filtration through normal pores between the endothelial cells in the microvasculature, due to the high arterial blood pressure.
- Published
- 1977
131. Effect of antihypertensive treatment on blood-retinal barrier permeability to fluorescein in hypertensive Type 1 (insulin-dependent) diabetic patients with background retinopathy
- Author
-
H. Lund-Andersen, H.-H. Parving, M. Larsen, and Eva Hommel
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,Captopril ,Endocrinology, Diabetes and Metabolism ,Blood–retinal barrier ,Urology ,Renal function ,Blood Pressure ,Diabetic nephropathy ,Furosemide ,Internal medicine ,Blood-Retinal Barrier ,Internal Medicine ,medicine ,Albuminuria ,Humans ,Diabetic Nephropathies ,Diabetic Retinopathy ,medicine.diagnostic_test ,business.industry ,Fundus photography ,Diabetic retinopathy ,Middle Aged ,Fluoresceins ,medicine.disease ,Fluorescein angiography ,Diabetes Mellitus, Type 1 ,medicine.anatomical_structure ,Endocrinology ,Bendroflumethiazide ,Female ,Fluorescein ,medicine.symptom ,business ,Glomerular Filtration Rate ,Retinopathy - Abstract
The effect of antihypertensive treatment on blood-retinal barrier leakage of fluorescein in background retinopathy was studied in nine hypertensive Type 1 (insulin-dependent) diabetic patients suffering from nephropathy. The patients were investigated before and after 7 (3 to 13) months of treatment with captopril (n = 8; 25 to 100 mg daily) and a diuretic, either frusemide (n = 4; 80 to 200 mg daily) or bendrofluazide (n = 2; 2.5 mg daily). Retinal function was assessed by fundus photography, fluorescein angiography, vitreous fluorometry, and renal function by glomerular filtration rate, and albuminuria. The antihypertensive treatment induced a significant reduction (p less than 0.05) in: blood pressure from 152/97 +/- 14/8 mmHg to 134/82 +/- 11/6 mmHg; blood-retinal barrier leakage of fluorescein from 2.4 +/- 1.1 to 1.4 +/- 0.5.10(-7) cm/second; albuminuria from 1391 (range: 168-4852) micrograms/min to 793 (range: 35-2081) micrograms/min. Glomerular filtration rate declined from 88 +/- 15 to 78 +/- 23 ml.min-1.1.73 m2 (0.05 less than p less than 0.10). The metabolic control of the patients as reflected by their blood glucose and HbA1c levels remained stable during the study. Our study suggests that systemic blood pressure elevation contributes to the abnormal blood-retinal barrier permeability to fluorescein characteristically found in diabetic background retinopathy and that this abnormality can be reversed during antihypertensive treatment.
- Published
- 1989
132. Reduced transcapillary escape of albumin during acute blood pressure-lowering in Type 1 (insulin-dependent) diabetic patients with nephropathy
- Author
-
H H Parving, U. M. Smidt, and J. Kastrup
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Hydrostatic pressure ,Renal function ,Clonidine ,Nephropathy ,Capillary Permeability ,Diabetic nephropathy ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Diabetic Nephropathies ,Serum Albumin ,business.industry ,Hemodynamics ,Albumin ,medicine.disease ,Human serum albumin ,Diabetes Mellitus, Type 1 ,Endocrinology ,Blood pressure ,Hypertension ,Albuminuria ,Female ,medicine.symptom ,business ,Diabetic Angiopathies ,medicine.drug - Abstract
The effect of acute arterial blood pressure lowering upon albumin extravasation was studied in 10 patients with nephropathy and retinopathy due to long-standing Type 1 (insulin-dependent) diabetes. The following variables were measured: transcapillary escape rate of albumin (initial disappearance of intravenously injected 125I-labelled human serum albumin), and urinary albumin excretion rate (radial immunodiffusion). The study was performed twice within 2 weeks, with the patients receiving an intravenous injection of either clonidine (225 micrograms) or saline (0.154 mmol/l). The clonidine injection induced the following changes: arterial blood pressure decreased from 134/87 to 107/73 mmHg (p less than 0.01), transcapillary escape rate of albumin declined from 8.1 to 6.7% of the intravascular mass of albumin/h (p less than 0.01), albuminuria diminished from 1434 to 815 micrograms/min (p less than 0.01), and plasma volume raised slightly from 2916 to 2995 ml (p less than 0.05). Our findings demonstrate that the enhanced albumin passage through the wall of the microvasculature characteristically found in long-term Type 1 diabetic patients with clinical microangiopathy is pressure-dependent to a large extent. This may be due to elevated hydrostatic pressure in the microcirculation.
- Published
- 1985
133. Arteriolar hyalinosis does not interfere with the local veno-arteriolar reflex regulation of subcutaneous blood flow in insulin-dependent diabetic patients
- Author
-
J. Kastrup, T. Nørgaard, H. -H. Parving, and N. A. Lassen
- Subjects
Clinical Biochemistry ,General Medicine - Published
- 1987
134. Hemodynamics in diabetic orthostatic hypotension
- Author
-
Henrik Galbo, Jannik Hilsted, Niels Juel Christensen, J Benn, and H H Parving
- Subjects
Adult ,Male ,Cardiac output ,Epinephrine ,Posture ,Hemodynamics ,Blood Pressure ,Plasma renin activity ,Norepinephrine (medication) ,Hypotension, Orthostatic ,Norepinephrine ,Orthostatic vital signs ,Diabetic Neuropathies ,Heart Rate ,Renin ,Heart rate ,Humans ,Insulin ,Medicine ,Cardiac Output ,Plasma Volume ,business.industry ,General Medicine ,Diabetes Mellitus, Type 1 ,Blood pressure ,medicine.anatomical_structure ,Anesthesia ,Vascular resistance ,Vascular Resistance ,business ,Research Article ,medicine.drug - Abstract
Hemodynamic variables (blood pressure, cardiac output, heart rate, plasma volume, splanchnic blood flow, and peripheral subcutaneous blood flow) and plasma concentrations of norepinephrine, epinephrine, and renin were measured in the supine position and after 30 min of quiet standing. This was done in normal subjects (n = 7) and in juvenile-onset diabetic patients without neuropathy (n = 8), with slight neuropathy (decreased beat-to-beat variation in heart rate during hyperventilation) (n = 8), and with severe neuropathy including orthostatic hypotension (n = 7). Blood pressure decreased precipitously in the standing position in the diabetics with orthostatic hypotension, whereas moderate decreases were found in the other three groups. Upon standing, heart rate rose and cardiac output and plasma volume decreased similarly in the four groups. The increases in total peripheral resistance, splanchnic vascular resistance and subcutaneous vascular resistance were all significantly lower (P less than 0.025) in the patients with orthostatic hypotension compared with the other three groups. The increase in plasma norepinephrine concentrations in the patients with orthostatic hypotension was significantly lower (P less than 0.025) than in the patients without neuropathy, whereas plasma renin responses to standing were similar in the four groups. We conclude that in diabetic hypoadrenergic orthostatic hypotension the basic pathophysiological defect is lack of ability to increase vascular resistance, probably due to impaired sympathetic activity in the autonomic nerves innervating resistance vessels; cardiac output and plasma volume responses to standing are similar to those found in normal subjects and in diabetics without neuropathy.
- Published
- 1981
135. Hypotensive Therapy Reduces Microvascular Albumin Leakage in Insulin-dependent Diabetic Patients with Nephropathy
- Author
-
H.-H. Parving and U. M. Smidt
- Subjects
Adult ,Male ,medicine.medical_specialty ,Hypertension, Renal ,Endocrinology, Diabetes and Metabolism ,Hydrostatic pressure ,Serum albumin ,Renal function ,Capillary Permeability ,Diabetic nephropathy ,Endocrinology ,Internal medicine ,Internal Medicine ,medicine ,Albuminuria ,Humans ,Diabetic Nephropathies ,Antihypertensive Agents ,Serum Albumin ,Thiazide ,biology ,business.industry ,Albumin ,medicine.disease ,Human serum albumin ,Diabetes Mellitus, Type 1 ,biology.protein ,Female ,medicine.symptom ,business ,medicine.drug - Abstract
The effect of hypotensive therapy on the transcapillary escape rate of albumin (TERalb) was studied in eight hypertensive insulin-dependent diabetic patients (mean age 29, range 19-42 years) with nephropathy and retinopathy. Transcapillary escape rate of albumin (initial disappearance of intravenously injected 125I-labelled human serum albumin), urinary albumin excretion rate (radial immunodiffusion), and glomerular filtrate rate (single bolus 51-Cr-EDTA technique) were measured. After hypotensive treatment (mean duration, 23 months, range 7-39 months) with combinations of metoprolol, hydralazine, and frusemide or thiazide diuretics, arterial blood pressure fell from 152/103 +/- 18/6 mmHg (mean +/- SD) to 133/81 +/- 12/10 mmHg (p less than 0.01), transcapillary escape rate of albumin from 10.2 +/- 1.8 to 8.1 +/- 1.8% of intravascular mass of albumin/h (p less than 0.01), albuminuria from 1803 (370-5066) micrograms/min to 940 (101-2676) micrograms/min (median and range, p less than 0.05), and glomerular filtration rate from 103 +/- 23 to 84 +/- 22 ml/min/1.73 m2 (p less than 0.01). Our study suggests that effective hypotensive treatment reduces the abnormally elevated albumin leakage characteristically found in insulin-dependent diabetic patients with clinical microangiopathy. This may be due to a reduction in the hydrostatic pressure in the microcirculation.
- Published
- 1986
136. Impaired autoregulation of blood flow in subcutaneous tissue of long-term Type 1 (insulin-dependent) diabetic patients with microangiopathy: an index of arteriolar dysfunction
- Author
-
T. Nørgaard, J. Kastrup, O. Henriksen, H. H. Parving, and Niels A. Lassen
- Subjects
Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Hemodynamics ,Blood Pressure ,Basement Membrane ,Diabetic Neuropathies ,Arteriole ,Internal medicine ,medicine.artery ,Internal Medicine ,medicine ,Homeostasis ,Humans ,Autoregulation ,Vein ,Skin ,Type 1 diabetes ,business.industry ,Microangiopathy ,Arteries ,Blood flow ,medicine.disease ,Arterioles ,Diabetes Mellitus, Type 1 ,Blood pressure ,medicine.anatomical_structure ,Endocrinology ,Regional Blood Flow ,Cardiology ,Female ,business ,Diabetic Angiopathies - Abstract
Autoregulation of blood flow in subcutaneous tissue was studied at the level of the lateral malleolus in eight long-term Type 1 (insulin-dependent) diabetic patients with clinical microangiopathy, eight short-term Type 1 diabetic patients without clinical microangiopathy and seven healthy control subjects. Blood flow was measured by the local 133Xenon washout technique. Mean arterial blood pressure was reduced by a maximum of 23 mmHg by elevating the limb above heart level and elevating to a maximum of 70 mmHg by head-up tilt; in the latter position venous pressure was kept constant and low by activation of the leg muscle vein pump (heel raising). Mean arterial blood pressure was thus varied between 60 and 160 mmHg. In normal and short-term diabetic subjects blood flow remained within 10% of control values during the changes in arterial blood pressure. In six of the eight Type 1 diabetic patients with clinical microangiopathy, autoregulation of blood flow was impaired, blood flow changing ap proximately 20% per 10 mmHg change in arterial blood pressure; the slope of the autoregulation curves was significantly higher compared with the two control groups (p
- Published
- 1985
137. Kidney function and size in normal subjects before and during growth hormone administration for one week
- Author
-
J. Gammelgaard, H. Ørskov, A. R. Andersen, S. Telmer, J. Sandahl Christiansen, and H H Parving
- Subjects
Adult ,Male ,medicine.medical_specialty ,Urinary system ,Clinical Biochemistry ,Extraction ratio ,Renal function ,Kidney ,urologic and male genital diseases ,Biochemistry ,Renal Circulation ,Internal medicine ,medicine ,Humans ,Renal circulation ,Chemistry ,Albumin ,Organ Size ,General Medicine ,Filtration fraction ,Diabetes Mellitus, Type 1 ,medicine.anatomical_structure ,Endocrinology ,Growth Hormone ,Renal blood flow ,Glomerular Filtration Rate - Abstract
Kidney function and size were studied in seven normal male subjects before and after administration of highly purified human growth hormone for 1 week. Glomerular filtration rate, renal plasma flow (steady-state infusion technique with urinary collections using 125I-iothalamate and 131I-hippuran) kidney size (ultrasonic scanning) and urinary excretion rates of albumin and beta 2-microglobulin (radioimmunoassays) were measured. Highly purified growth hormone was injected subcutaneously, 2 IU in the morning and 4 IU in the evening. Glomerular filtration rate increased from (mean +/- SEM) 114 +/- 5 to 125 +/- 4 ml/min x 1.73 m2 (P less than 0.01) and renal plasma flow increased from 554 +/- 30 to 601 +/- 36 ml/min x 1.73 m2 (P less than 0.01). Kidney size and urinary excretion rates of albumin and beta 2-microglobulin did not change significantly. Our results show that raising plasma growth hormone into a range similar to that found in insulin-dependent diabetics enhances glomerular filtration rate and renal plasma flow, while kidney size remains unchanged. Increased renal plasma flow is the major determinant of growth hormone induced elevation in glomerular filtration rate. Growth hormone may thus contribute to the enhancement of glomerular filtration rate and renal plasma flow typically found in insulin-dependent diabetics.
- Published
- 1981
138. Effect of captopril on kidney function in insulin-dependent diabetic patients with nephropathy
- Author
-
Jørn Giese, B Edsberg, Eva Hommel, M. Damkjaer Nielsen, Elisabeth R. Mathiesen, and H.-H. Parving
- Subjects
Adult ,Male ,medicine.medical_specialty ,Captopril ,Renal function ,Blood Pressure ,Kidney ,Nephropathy ,Diabetic nephropathy ,Internal medicine ,Renin–angiotensin system ,medicine ,Albuminuria ,Humans ,Diabetic Nephropathies ,General Environmental Science ,business.industry ,Angiotensin II ,General Engineering ,General Medicine ,Middle Aged ,medicine.disease ,Blood pressure ,Endocrinology ,General Earth and Planetary Sciences ,Female ,medicine.symptom ,business ,Research Article ,Glomerular Filtration Rate ,medicine.drug - Abstract
The influence of angiotensin II on kidney function in diabetic nephropathy was assessed by studying the effect of 12 weeks' monotherapy with captopril (25-50 mg twice a day) in 16 hypertensive insulin dependent diabetic patients with persistent albuminuria. In an initial one week randomised single blind trial of captopril versus placebo, captopril (for nine patients) reduced arterial blood pressure from 148/94 (SD11/6) to 135/88 (8/7) mm Hg (p less than 0.05) and albuminuria from 1549 (range 352-2238) to 1170 (297-2198) micrograms/min (p less than 0.05), while glomerular filtration rate remained stable. No significant changes occurred in seven patients treated with placebo. During the 12 weeks of captopril treatment arterial blood pressure in all patients fell from 147/94 (11/6) to 135/86 (13/7) mm Hg (p less than 0.01), albuminuria fell from 1589 (range 168-2588) to 1075 (35-2647) micrograms/min (p less than 0.01), and glomerular filtration rate fell from 99 (SD19) to 93 (25) ml/min/1.73 m2 (p less than 0.01). The renin-angiotensin system showed suppressed plasma concentrations of angiotensin II and increased concentrations of angiotensin I and renin. The study showed that glomerular filtration rate is not dependent on angiotensin II, that captopril reduces albuminuria, probably by lowering glomerular hypertension, and that captopril represents a valuable new drug for treating hypertension in diabetics dependent on insulin with nephropathy.
- Published
- 1986
139. Increased Transcapillary Escape Rate of Albumin, IgG, and IgM during Angiotensin-II-Induced Hypertension in Man
- Author
-
H. H. Parving, S. L. Nielsen, and N. A. Lassen
- Subjects
Clinical Biochemistry ,General Medicine - Published
- 1974
140. Effects of indomethacin on kidney function in Type 1 (insulin-dependent) diabetic patients with nephropathy
- Author
-
H. H. Parving, B Edsberg, S. Arnold-Larsen, U. B. Olsen, Elisabeth R. Mathiesen, and Eva Hommel
- Subjects
Adult ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Urinary system ,Indomethacin ,Kidney Glomerulus ,Renal function ,Dinoprostone ,Nephropathy ,Diabetic nephropathy ,Excretion ,Random Allocation ,Double-Blind Method ,Internal medicine ,Internal Medicine ,medicine ,Albuminuria ,Humans ,Diabetic Nephropathies ,Prostaglandin E2 ,Type 1 diabetes ,business.industry ,Prostaglandins E ,Middle Aged ,medicine.disease ,Diabetes Mellitus, Type 1 ,Endocrinology ,Female ,medicine.symptom ,business ,Glomerular Filtration Rate ,medicine.drug - Abstract
We investigated whether the glomerular synthesis of prostaglandins modulates the glomerular filtration rate and albuminuria in diabetic nephropathy. The urinary excretion of immunoreactive prostaglandin E2 (253 pg/min) was significantly elevated in eight Type 1 (insulin-dependent) diabetic women with nephropathy as compared with nine normoalbuminuric Type 1 diabetic women (95 pg/min) and 11 non-diabetic women (132 pg/min), respectively (p less than 0.01). Glomerular filtration rate (single bolus 51Cr-EDTA technique) and albuminuria (radioimmunoassay) were measured twice within two weeks in the eight Type 1 diabetic women with nephropathy. All eight patients were on a diabetic diet without sodium restriction. The study was performed as a randomized double-blind trial, with the patients receiving either indomethacin (150 mg/day) or placebo for three days prior to the kidney function studies. Indomethacin treatment induced a significant reduction in urinary prostaglandin E2 excretion (73%, p less than 0.01), glomerular filtration rate diminished from 120 +/- 18 to 106 +/- 17 ml/min/1.73 m2 (p less than 0.05), albuminuria declined from 148 to 69 micrograms/min (median and range) (p less than 0.05) and fractional clearance of albumin diminished 42% (p less than 0.05). Blood glucose concentrations were comparable during the placebo and indomethacin treatment, 13.4 +/- 4 versus 14.2 +/- 3 mmol/l, respectively. Our results suggest that glomerular filtration rate in early diabetic nephropathy is dependent on the enhanced glomerular synthesis of vasodilating prostaglandins.
- Published
- 1987
141. Increased Metabolic Turnover Rate and Transcapillary Escape Rate of Albumin in Essential Hypertension
- Author
-
H H Parving, N. Rossing, and Henrik Ae. Jensen
- Subjects
Male ,medicine.medical_specialty ,Body Surface Area ,Physiology ,Vascular permeability ,Plasma volume ,Essential hypertension ,Capillary Permeability ,Internal medicine ,medicine ,Humans ,Escape rate ,Plasma Volume ,Serum Albumin, Radio-Iodinated ,Chemistry ,Body Weight ,Albumin ,medicine.disease ,Body Height ,Surgery ,Blood pressure ,Endocrinology ,Turnover ,Hypertension ,Metabolic rate ,Female ,Cardiology and Cardiovascular Medicine - Abstract
The metabolic turnover rate and the transcapillary escape rate of albumin were studied using 131 I-labeled human albumin in nine untreated subjects suffering from essential hypertension. The average mean arterial blood pressure of these subjects was 162/109 mm Hg; seven subjects had grade I-II funduscopic changes. Plasma albumin concentration was normal, but plasma volume was reduced ( P < 0.05) in these subjects. Thus, the previously reported moderate decrease in the intravascular albumin mass of hypertensive subjects was confirmed; the average value for intravascular albumin mass in the present study was 62.8 g/m2 surface area compared with a normal value of 70.6 g/m 2 (-11%, P < 0.05). A surprising finding was a marked enhancement of albumin metabolic rate in essential hypertension. The fraction of intravascular albumin mass metabolized per 24-hour period was on the average 14.4% compared with a normal value of 8.4% (+72%, P < 0.001). The rate of synthesis was 9.1 g/24 hours m -2 compared with a normal value of 5.9 g/24 hours m -2 (+54%, P < 0.001). Total body albumin mass was decreased proportionally to intravascular albumin mass. Confirming a previous observation, we found an increase in the transcapillary escape rate of albumin (fraction of intravascular mass passing to the extravascular space per unit time) from a normal average of 5.6%/hour to 7.5%/hour (+34%, P < 0.001). There was a statistically significant positive correlation between the transcapillary escape rate of albumin and blood pressure ( P < 0.05). These findings can best be explained by increased filtration due to the high arterial blood pressure. There was also a positive correlation between the transcapillary escape rate and the fractional catabolic rate of albumin ( P < 0.05). This finding supports the concept that albumin is catabolized in connection with its permeation through the capillary endothelium.
- Published
- 1974
142. Audiological and Temporal Bone Findings in Myxedema
- Author
-
P. Bretlau, A. Parving, J. M. Hansen, B. Ostri, and H.-H. Parving
- Subjects
Adult ,Male ,Aging ,medicine.medical_specialty ,Hearing loss ,Observation period ,Population ,Levothyroxine ,03 medical and health sciences ,Audiological evaluation ,0302 clinical medicine ,Myxedema ,Temporal bone ,medicine ,Humans ,Hearing Loss ,030223 otorhinolaryngology ,education ,Aged ,Glycosaminoglycans ,education.field_of_study ,business.industry ,Temporal Bone ,Auditory Threshold ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Thyroxine ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Female ,medicine.symptom ,business ,After treatment ,medicine.drug - Abstract
Fifteen patients with confirmed myxedema at a median age of 48 years (range 32 to 60 years) were referred for audiological evaluation before and after treatment with levothyroxine. The median interval between the pretreatment and posttreatment investigations was 18 months (range 9 to 27 months). In addition, 13 patients at a median age of 78 years (range 64 to 95 years) were audiologically reexamined after long-standing levothyroxine treatment. The observation period upon treatment with levothyroxine was 40 months (range 32 to 46 months). No improvement in hearing sensitivity could be demonstrated either in the younger patients or in the elderly. When compared to an age- and sex-matched unscreened population, the myxedematous patients did not demonstrate any different degree of hearing loss. Histological investigation of the temporal bones from an 83-year-old woman with myxedema, however, showed no morphological changes or deposition of glycosaminoglycans, changes which are compatible with true age-related hearing loss. It is concluded that no association exists between myxedema and hearing impairment and that no morphological or structural changes due to myxedema can be demonstrated in the temporal bones.
- Published
- 1986
143. Eighth annual meeting of the European Association for the Study of Diabetes
- Author
-
K. G. M. M. Alberti, J. Darley, Pauline M. Emerson, T. D. R. Hockaday, M. Amherdt, A. A. Like, B. Blondel, B. Marliss, C. Wollheim, L. Orci, O. Ortved Andersen, Arne Andersson, F. M. Antonini, C. Fumagalli, E. Petruzzi, G. Bertini, S. Mori, P. Tinti, S. J. H. Ashcroft, L. C. C. Weerasinghe, P. J. Randle, R. Assan, N. Slusher, B. Guy-Grand, F. Girard, E. Soufflet, J. R. Attali, G. Ballerio, J. Boillot, T. Atkins, A. J. Matty, C. J. Bailey, A. Aynsley-Green, S. R. Bloom, R. A. Bacchus, L. G. Meade, D. R. London, L. Balant, G. Zahnd, B. Petitpierre, J. Fabre, E. O. Balasse, M. A. Neef, L. Barta, G. Brooser, Maria Molnar, D. P. Bataille, P. Freychet, P. Kitabgi, G. E. Rosselin, Christian Berne, J. Beyer, U. Cordes, G. Sell, C. Rosak, K. Schöffling, B. Birkner, J. Henner, P. Wagner, F. Erhardt, P. Dieterle, N. J. A. Vaughan, A. V. Edwards, L. Boquist, I. Brand, H. D. Söling, D. Brandenburg, J. Gliemann, H. A. Ooms, W. Puls, A. Wollmer, R. A. Camerini-Davalos, J. M. B. Bloodworth, B. Limburg, W. Oppermann, A. K. Campbell, K. Siddle, J. M. Cañadell, J. Barraquer, A. Muiños, C. D. Heredia, J. Castillo-Olivares, J. Guijo, L. F. Pallardo, E. Cerasi, S. Efendić, R. Luft, J. Wahren, P. Felig, Niels Juel Christensen, A. H. Christiansen, A. Vølund, J. J. Connon, E. Trimble, G. Copinschi, R. Leclercq, O. D. Bruno, E. Haupt, C. Creutzfeldt, N. S. Track, G. S. Cuendet, C. B. Wollheim, D. P. Cameron, W. Stauffacher, E. B. Marliss, A. Czyzyk, B. Lao, W. Bartosiewicz, Z. Szczepanik, E. De Nobel, A. Van't Laar, R. A. P. Koene, Th. J. Benraad, G. Dietze, K. D. Hepp, M. Wickmayr, H. Mehnert, K. Dixon, P. D. Exon, H. R. Hughes, D. W. Jones, R. S. Elkeles, M. G. FitzGerald, J. M. Malins, A. Falorni, F. Massi-Benedetti, G. Gallo, S. Maffei, D. Fedele, A. Tiengo, M. Muggeo, P. Fabris, G. Crepaldi, K. Federlin, K. Helmke, M. Slijepčević, E. F. Pfeiffer, J. P. Felber, J. Oulès, Ch. Schindler, V. Chabot, A. Fernandez-Cruz, E. Catalán, M. Luque Otero, O. Garcia Hermida, J. P. Flatt, G. Blackburn, G. Randers, H. Förster, I Hoos, D. Lerche, I. Hoos, M. Matthäus, J. R. M. Franckson, H. Frerichs, H. Daweke, F. Gries, D. Grüneklee, J. Hessing, K. Jahnke, U. Keup, H. Miss, H. Otto, D. Schmidt, C. Zumfelde, H. v. Funcke, G. Löffler, O. Wieland, D. J. Galton, R. Guttman, G. C. Gazzola, R. Franchi, P. Ronchi, V. Saibene, G. G. Guidotti, V. Gligore, N. Hîncu, Rodica Tecuceanu, R. Goberna, F. Garcia-Albertos, J. Tamarit-Rodriguez, E. del Rio, R. Roca, José Gomez-Acebo, A. V. Creco, G. Fedeli, G. Ghirlanda, R. Fenici, M. Lucente, A. Gutman, G. Agam, N. Nahas, P. Cazalis, E. Gylfe, B. Hellman, D. R. Hadden, J. H. Connolly, D. A. D. Montgomery, J. A. Weaver, Claes Hellerström, Simon Howell, John Edwards, J. Sehlin, I. -B. Täljedal, W. Heptner, H. B. Neubauer, A. Herchuelz, D. G. Pipeleers, W. J. Malaisse, E. Herrera, Eladio Montoya, H. Hommel, IT. Fischer, B. Schmid, H. Fiedler, H. Bibergeil, J. Iversen, P. B. Iynedjian, G. Peters, C. Jacquemin, B. Lambert, B. Ch. J. Sutter, A. Jakob, J. Zapf, E. R. Froesch, F. K. Jansen, G. Freytag, L. Herberg, R. J. Jarrett, I. A. Baker, C. Jarrousse, F. Rancon, D. Job, G. Tchobroutsky, E. Eschwege, C. Guyot-Argenton, J. P. Aubry, M. Déret, H. Karman, P. Mialhe, A. Kissebah, B. Tulloch, Russell Fraser, N. Vydelingum, J. Kissing, S. Raptis, H. Dollinger, J. Faulhaber, G. Rothenbuchner, J. Kleineke, H. Sauer, J. Kloeze, Eva M. Kohner, Barbara A. Sutcliffe, M. Tudball, C. T. Dollery, W. Korp, J. Neubert, H. Bruneder, A. Lenhardt, R. E. Levett, T. Koschinsky, F. A. Gries, M. M. C. Landgraf-Leurs, R. Landgraf, R. Hörl, D. R. Langslow, H. Laube, R. Fussgänger, R. Mayer, H. Klör, E. Lázaro, V. Leclercq-Meyer, J. J. Marchand, W. Malaisse, Thomas Ledet, P. J. Lefébvre, A. S. Luyckx, Y. Le Marchand, F. Assimacopoulos, A. Singh, Ch. Rouiller, B. Jeanrenaud, G. Lenti, R. Frezzotti, G. Angotzi, A. M. Bardelli, G. Pagano, A. Basetti-Sani, M. Galli, Å. Lernmark, G. Fex, D. G. Lindsay, O. Loge, C. Lopez-Quijada, L. Chiva, M. Rodriguez-Lopez, E. G. Loten, A. L. Loubatières, M. M. Loubatières-Mariani, G. Ribes, J. Chapal, J. Lubetzki, J. Duprey, Cl. Sambourg, P. J. Lefebvre, V. Maier, M. Hinz, H. Schatz, C. Nierle, F. Malaisse-Lagae, M. Ravazzola, A. E. Renold, P. Manzano, E. Rojas-Hidalgo, J. Marco, D. Diaz-Fierros, C. Calle, D. Roman, M. L. Villanueva, I. Valverde, A. Like, A. L. Luycks, F. Fracassini, R. Menzel, D. Michaelis, I. Neumann, B. Schulz, W. Wilke, P. Wulfert, K. Krämer, G. Menzinger, F. Fallucca, F. Tamburrano, R. Carratu', D. Andreani, P. Metzger, P. Franken, R. Michael, W. Hildmann, E. Jutzi, J. Michl, S. Fankhauser, J. Schlichtkrull, J. Mirouze, A. Orsetti, Y. Vierne, N. Arnoux, L. Mølsted-Pederson, Inge Tygstrup, Åge L. Villumsen, Jørgen Pedersen, W. Montague, S. L. Howell, A. J. Moody, G. S. Agerbak, F. Sundby, A. Baritussio, Peter Naeser, R. Navalesi, A. Pilo, S. Lenzi, P. Cecchetti, G. Corsini, L. Donato, J. Nerup, G. Bendixen, J. Egeberg, J. E. Poulsen, J. Høiriis Nielsen, F. Mølgaard Hansen, A. Niki, H. Niki, T. Koide, B. J. Lin, R. E. Nikkels, J. Terpstra, A. Gay, R. H. Oakman, Norman R. Lazarus, C. Rouiller, J. Ostman, L. Backman, D. Hallberg, K. Ostrowski, U. Panten, J. Christians, H. -H. Parving, S. Munkgaard Rasmussen, M. Marichal, H. Platilovà, M. Dufek, E. Konopàsek, V. Pozuelo, J. Tamarit, A. Suner, C. Castell, E. D. R. Pruett, S. Maehlum, B. Grebe, M. Chrissiku, R. Müller, H. J. Hinze, H. Reinauer, E. R. Müller-Ruchholtz, X. Rietzler, P. Passa, J. Canivet, J. Otto, G. Behrens, T. Bücher, U. Schlumpf, B. Morell, A. Zingg, J. Schönborn, P. Westphal, G. D. Bloom, L. -A. Idahl, A. Lernmark, M. Söderberg, M. Serrano Rios, F. G. Hawkins, F. Escobar, J. M. Mato, L. Larrodera, M. de Oya, J. L. Rodriguez-Miñon, E. Shafrir, G. Sitbon, Z. Skrabalo, N. Panajatović, Z. Papić, J. Posinovec, A. Stavljenić, V. Lipovac, I. Aganović, N. G. Soler, M. A. Bennett, H. Peters, G. Janson, P. H. Sönksen, M. C. Srivastava, C. V. Tompkins, J. D. N. Nabarro, N. Schwartz Sørensen, K. Ladefoged, K. E. Wildenhoff, F. Sorge, H. -J. Diehl, H. Hoffmann, W. Schwartzkopff, E. Standl, H. Kolb, A. Standl, H. W. Sutherland, J. M. Stowers, J. C. G. Whetham, B. C. J. Sutter, B. Billaudel, M. T. Sutter-Dub, R. Jacquot, I. B. Täljedal, R. Gobema, Gy. Tamás, Éva Baranyi, A. Baranyi, A. Radvanyi, J. Tatoń, A. Hinek, A. Wiśniewska, R. B. Tattersall, D. A. Pyke, J. Bruins Slot, P. L. M. v. d. Sande, J. K. Radder, K. J. J. Waldeok, R. C. P. A. v. Muijden, W. Creutzfeldt, D. S. Turner, R. W. Baker, W. G. L. Gent, A. Shabaan, V. Marks, D. A. B. Young, Ph. Vague, H. Heim, C. Martin Laval, M. Vegezzi, C.Di Campo, G. Rahamandridona, D. Garron, B. Heyraud, J. Vague, I. Lozano, M. Diaz-Fierros, F. A. Van Assche, W. Gepts, E. Van Obberghen, G. Somers, G. Devis, G. D. Vaughan, J. Veleminsky, E. Spirova, W. Waldhäusl, H. Frisch, H. Haydl, L. Weiss, B. Willms, U. Deuticke, M. Zrůstová, and J. Roštlapil
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0303 health sciences ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Association (object-oriented programming) ,030209 endocrinology & metabolism ,Human physiology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Family medicine ,Internal Medicine ,medicine ,business ,030304 developmental biology - Published
- 1973
144. Human Red Cell Metabolism and in Vivo Oxygen Affinity of Red Cells during 24 Hours' Exposure to Simulated High Altitude (4500 m)
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T. Kalsig, Susan F. Nygaard, M. Rörth, H. H. Parving, and V. Hansen
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Adult ,Male ,Erythrocytes ,Time Factors ,Partial Pressure ,Clinical Biochemistry ,Stimulation ,Phosphates ,Hemoglobins ,Leukocyte Count ,chemistry.chemical_compound ,Extracellular fluid ,Humans ,Purine Nucleotides ,Glyceraldehyde 3-phosphate dehydrogenase ,biology ,Red Cell ,General Medicine ,Carbon Dioxide ,Hydrogen-Ion Concentration ,Effects of high altitude on humans ,Phosphate ,Oxygen ,Atmospheric Pressure ,Blood ,Hematocrit ,chemistry ,Biochemistry ,Erythrocyte Count ,biology.protein ,NAD+ kinase ,Glycolysis ,Phosphofructokinase - Abstract
During exposure to high altitude the red cell metabolism was stimulated. An increase in the phosphofructokinase reaction occurred secondary to the elevated blood pH. An increase in the triosephosphate pool occurred secondary to PFK stimulation and a relative inhibition of the GAPDH reaction, which was due to the decrease in the concentration of inorganic phosphate. The low inorganic phosphate levels in both red cells and plasma were a consequence of a shift of phosphate from the extracellular fluid to other body cells during hyperventilation. The forward reaction of GAPDH was stimulated when the exposure to high altitude was accompanied by a moderate degree of physical exercise. This was indicated by the significant increase in red cell levels of 2,3-DPG, and 3PG and 2PG. This stimulation of the GAPDH reaction was probably due to an increased availability of NAD+, brought about by the influx of pyruvate from the muscles. The changes in the red cell metabolism influenced their oxygen affinity through chang...
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- 1973
145. pH Effect on Erythropoietin Response to Hypoxia
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H. H. Parving, Donald Howard, Frederick Stohlman, C. R. Valeri, Marilyn E. Miller, Michael Rørth, and Irene Reddington
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Adult ,Male ,medicine.medical_specialty ,Erythrocytes ,Alkalosis ,Urinary system ,Urine ,Hemoglobins ,Hypocapnia ,Internal medicine ,medicine ,Humans ,Hypoxia ,Erythropoietin ,Acid-Base Equilibrium ,business.industry ,Altitude ,Phosphorus ,General Medicine ,Carbon Dioxide ,Hydrogen-Ion Concentration ,Diphosphoglyceric Acids ,medicine.disease ,Capillaries ,Acetazolamide ,Oxygen ,Blood ,Endocrinology ,Respiratory alkalosis ,Acid–base reaction ,business ,Alkalosis, Respiratory ,medicine.drug - Abstract
Six normal volunteers were exposed to a simulated altitude of 4500 meters, and changes in urine and serum erythropoietin levels were related to the changes in acid-base status. During the initial six hours of exposure the volunteers had respiratory alkalosis, which produced a definite increase in red-cell oxygen affinity. These conditions were associated with an increase in urinary and serum erythropoietin. The continued alkalosis and hypocapnia gradually raised red-cell 2,3-diphosphoglycerate concentrations and lowered red-cell oxygen affinity. These changes are thought to lead to the decreased erythropoietin concentration seen after continued exposure. Treatment of the same volunteers with acetazolamide prevented the initial respiratory alkalosis and reduced erythropoietin response. These findings demonstrate that erythropoietin concentrations in urine and serum were influenced by the acid-base status of the volunteers.
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- 1973
146. Simultaneous Determination of the Transcapillary Escape Rate of Albumin and IgG in Normal and Long-Term Juvenile Diabetic Subjects
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H H Parving and N Rossing
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Adult ,Male ,medicine.medical_specialty ,Body Surface Area ,Clinical Biochemistry ,Serum albumin ,Vascular permeability ,Diabetic angiopathy ,Immunoglobulin G ,Capillary Permeability ,Iodine Radioisotopes ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Serum Albumin ,Body surface area ,biology ,Chemistry ,Microangiopathy ,Albumin ,General Medicine ,Middle Aged ,medicine.disease ,Diabetes Mellitus, Type 1 ,Endocrinology ,Immunology ,biology.protein ,Diabetic Angiopathies - Abstract
Transcapillary escape rates of albumin and IgG (fractions of intravascular mass of albumin and IgG that pass to the extravascular space per unit time) were determined simultaneously from the initial disappearance of intravenously injected 131I human albumin and 125I human IgG, in 10 long-term juvenile diabetics with microangiopathy (mean duration 20 years), and 9 non-diabetic subjects. Transcapillary escape rates of albumin (TERalb) and IgG (TERIgG) were found significantly increased in the long-term diabetic group, average 7.4 ± 1.1 (mean ± S.D.) and 4.4 ± 1.0 per cent/hour, respectively, compared to the non-diabetic group, mean 5.2 ± 1.0 and 3.0 ± 0.7 per cent/hour, respectively (p < 0.005). The TERIgG/TERalb ratio was nearly identical in the two groups, and very close to the ratio of the proteins' free diffusion coefficients. We assume that the present findings reflect an increased microvascular permeability to macromolecules, owing to an increased number or size of the large pores per unit sur...
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- 1973
147. Increased serum potassium affects renal outcomes: a post hoc analysis of the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) trial
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H. H. Parving, D. E. Grobbee, Mark E. Cooper, Barry M. Brenner, Dick de Zeeuw, Yan Miao, Daniela Dobre, Shahnaz Shahinfar, H. J. Lambers Heerspink, Groningen Kidney Center (GKC), and Methods in Medicines evaluation & Outcomes research (M2O)
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CHRONIC KIDNEY-DISEASE ,Male ,medicine.medical_specialty ,Angiotensin receptor ,HYPOALDOSTERONISM ,Hyperkalemia ,Endocrinology, Diabetes and Metabolism ,Urology ,Type 2 diabetes ,ALDOSTERONE SYSTEM ,urologic and male genital diseases ,HYPERKALEMIA ,Article ,Losartan ,Nephropathy ,Internal medicine ,Diabetes mellitus ,medicine ,Internal Medicine ,Humans ,Diabetic Nephropathies ,Angiotensin receptor blocker ,RISK ,business.industry ,Middle Aged ,medicine.disease ,Angiotensin II ,Endocrinology ,Diabetes Mellitus, Type 2 ,Potassium ,HEART-FAILURE ,Female ,sense organs ,medicine.symptom ,business ,INHIBITORS ,Angiotensin II Type 1 Receptor Blockers ,Kidney disease ,medicine.drug - Abstract
To assess the effect of an angiotensin receptor blocker (ARB) on serum potassium and the effect of a serum potassium change on renal outcomes in patients with type 2 diabetes and nephropathy.We performed a post hoc analysis in patients with type 2 diabetes participating in the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) study. Renal outcomes were defined as a composite of doubling of serum creatinine or end-stage renal disease.At month 6, 259 (38.4%) and 73 (10.8%) patients in the losartan group and 151 (22.8%) and 34 (5.1%) patients in the placebo group had serum potassium a parts per thousand yen5.0 mmol/l and a parts per thousand yen5.5 mmol/l, (p In this study, we found that treatment with the ARB losartan is associated with a high risk of increased serum potassium levels, which is in turn associated with an increased risk of renal outcomes in patients with diabetes and nephropathy. Whether additional management of high serum potassium would further increase the renal protective properties of losartan is an important clinical question.
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148. INCREASED URINARY ALBUMIN-EXCRETION RATE IN BENIGN ESSENTIAL HYPERTENSION
- Author
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H.Æ Jensen, P. E. Evrin, Carl Erik Mogensen, and H.-H Parving
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Male ,medicine.medical_specialty ,Cell Membrane Permeability ,Globulin ,Urinary system ,Kidney Glomerulus ,Radioimmunoassay ,Urology ,Renal function ,Excretion ,Internal medicine ,medicine ,Albuminuria ,Humans ,Benign Essential Hypertension ,biology ,business.industry ,Albumin ,Blood Pressure Determination ,Globulins ,General Medicine ,Circadian Rhythm ,Kidney Tubules ,Endocrinology ,Renal physiology ,Hypertension ,biology.protein ,Female ,medicine.symptom ,business ,Glomerular Filtration Rate - Abstract
The daily urinary albumin-excretion rate was measured by a sensitive radioimmunoassay in eight normal subjects (average blood-pressure 126/83 mm. Hg), fourteen patients effectively treated for benign essential hypertension (average blood-pressure 143/89 mm. Hg), and eighteen untreated or insufficiently treated patients with benign essential hypertension (average blood-pressure 182/ 112 mm. Hg). None of the patients had albuminuria as judged by the 'Albustix' test. Albumin excretion was significantly increased in the insufficiently treated hypertensive group compared with the average normal value of 8.5 mg. per 24 hours. Five hypertensive patients had a distinctly increased albumin-excretion rate (mean 87 mg. per 24 hours), while a more moderate but still statistically significant increase was found in the remaining thirteen (mean 16.9mg. per 24 hours). The excretion-rate was normal in the patients treated effectively for hypertension (mean 7.8 mg. per 24 hours). Since the daily urinary 2–microglobulin-excretion rate was normal in the patients, indicating a normal tubular reabsorption of protein, it is concluded that transglomerular passage of albumin is increased in benign essential hyper-tension. This finding is compatible with the hypothesis that hypertensive extravasation of plasma- proteins, with subsequent deposition in the vascular wall-i.e., the concept of plasmatic vasculosis.
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- 1974
149. Myxoedema and Raynaud's phenomenon
- Author
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H-H. Parving, S. L. Nielsen, and J. E. M. Hansen
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Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Blood Pressure ,Sympathetic discharge ,Endocrinology ,Internal medicine ,Myxedema ,medicine ,Humans ,Pulse ,Aged ,business.industry ,Raynaud Disease ,General Medicine ,Middle Aged ,Cold Temperature ,Thyroxine ,Cardiology ,Cold sensitivity ,Female ,medicine.symptom ,business ,After treatment - Abstract
Cold hands is a common complaint in myxoedema and were reported by 15 of 17 patients before treatment of myxoedema with 4 having Raynaud's phenomenon. An increased cold sensitivity of the digital arteries could be demonstrated during finger cooling in about half of the patients and Raynaud's phenomenon was verified in the 4 patients as digital arterial closure. The cold sensitivity decreased significantly after treatment with L-thyroxine. The increased cold sensitivity in untreated myxoedema is probably due to an increased sympathetic discharge to the hands that might disclose a predisposition for Raynaud's phenomenon.
- Published
- 1982
150. Monitoring kidney function in diabetic nephropathy
- Author
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S Groth, H.-H. Parving, C. Petersen, and A. Dirksen
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Adult ,Male ,medicine.medical_specialty ,Urology ,Renal function ,Intravenous bolus ,Kidney Function Tests ,Nephropathy ,Diabetic nephropathy ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Diabetic Nephropathies ,Edetic Acid ,Monitoring, Physiologic ,Plasma samples ,business.industry ,Venous blood ,Middle Aged ,medicine.disease ,Chromium Radioisotopes ,Endocrinology ,Multiple sampling ,Female ,business ,Glomerular Filtration Rate - Abstract
We investigated the validity of a one plasma sample method (I) compared with a multiple plasma sample method (II) for routine clinical determination of glomerular filtration rate (GFR) in 35 insulin-dependent diabetic patients suffering from nephropathy. GFR was measured after an intravenous bolus injection of 100 microCi 51Cr-EDTA by determination of plasma radioactivity in venous blood samples taken from the other arm 180, 200, 220 and 240 min after the injection (II). The plasma radioactivity in the sample drawn 240 min after injection was used in method I. During the mean investigation period of 32 months (12-62 months) a total of 184 GFR determinations were performed. The average interval between the GFR measurements was 6 months (1-21 months). In 127/184 of the study intervals method I indicated a decrease in GFR. The corresponding figure for method II was almost identical, 130/184. The mean decline in GFR was 8.1 +/- 7.2 and 7.8 +/- 6.9 ml year-1 1.73 m-2 using methods I and II, respectively (NS). The methods essentially provided the same GFR values in absolute terms (r = 0.98, P less than 0.001). We conclude that the one plasma sample method can be used as a valid routine technique in non-uraemic patients with nephropathy.
- Published
- 1989
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