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Glucose-induced changes in renal haemodynamics in proteinuric type 1 (insulin-dependent) diabetic patients: inhibition by acetylsalicilic acid infusion.
- Source :
-
Diabetologia [Diabetologia] 1993 Jul; Vol. 36 (7), pp. 622-7. - Publication Year :
- 1993
-
Abstract
- The effect of hyperglycaemia on renal function in diabetic nephropathy remains poorly understood. We investigated the renal haemodynamic response to an acute plasma glucose rise from sustained euglycaemia to sustained hyperglycaemia in eight persistently proteinuric Type 1 (insulin-dependent) diabetic patients. Studies were performed in a double-blind cross-over manner after i.v. injection of 450 mg lysine acetylsalicilate (equivalent to 250 mg acetylsalicilic acid) or equal volume of 0.9% NaCl (isotonic saline). In the isotonic saline experiments hyperglycaemia produced a significant rise, by approximately 35%, in glomerular filtration rate in all patients from 41.5 +/- 5.2 to 55 +/- 6 ml.min-1.1.73 m-2 (p < 0.005) and an increase in sodium paraminohippurate clearance from 178 +/- 22.7 to 220 +/- 20.0 ml.min-1.1.73 m-2 (p < 0.05). These changes took place within the first 30 min of glucose infusion and were maintained for a 90 min hyperglycaemic period. Filtration fraction did not change significantly. Infusion of lysine acetylsalicilate lowered baseline glomerular filtration rate (isotonic saline vs lysine acetylsalicilate 41.5 +/- 5.2 vs 30.0 +/- 5.7 ml.min-1.1.73 m-2; p < 0.05) and significantly blunted the rise in glomerular filtration rate during hyperglycaemia (glomerular filtration rate increment: saline vs lysine acetylsalicilate: 13.6 +/- 2.8 vs 5.3 +/- 1.8 ml.min-1.1.73 m-2; p < 0.005). The effects on renal plasma flow were similarly blunted. In five additional patients, time- and volume-controlled isotonic saline experiments during sustained euglycaemia showed no significant changes in glomerular filtration rate and sodium paraminohippurate clearance.(ABSTRACT TRUNCATED AT 250 WORDS)
- Subjects :
- Adult
Analysis of Variance
Biopsy
Diabetes Mellitus, Type 1 pathology
Diabetes Mellitus, Type 1 urine
Diabetic Nephropathies pathology
Diabetic Nephropathies urine
Female
Glucose Clamp Technique
Hematocrit
Humans
Male
Middle Aged
Vascular Resistance drug effects
p-Aminohippuric Acid
Aspirin pharmacology
Blood Proteins metabolism
Diabetes Mellitus, Type 1 physiopathology
Diabetic Nephropathies physiopathology
Glomerular Filtration Rate drug effects
Glucose pharmacology
Proteinuria
Renal Circulation drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 0012-186X
- Volume :
- 36
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Diabetologia
- Publication Type :
- Academic Journal
- Accession number :
- 8359579
- Full Text :
- https://doi.org/10.1007/BF00404071