Affiliation:
1. Steno Memorial Hospital, Gentofte, and Department of Clinical Physiology and Department of Medicine C, Bispebjerg Hospital Copenhagen
Abstract
Urinary albumin excretion rate (radial immunodiffusion), glomerular filtration rate (GFR) (single-shot 51Cr-EDTA technique), and arterial blood pressure (BP) were measured in 12 juvenile-onset, insulin-dependent diabetic patients with persistent proteinuria (> 0.5 g/day) due to diabetic nephropathy. Mean age of the patients was 30 yr. All patients had a diastolic blood pressure ≥95 mm Hg. Metoprolol, hydralazine, and furosemide or thiazide were used as antihypertensives. During the 12-mo treatment period, BP decreased from 151/104 to 133/85 mm Hg (P < 0.001), the urinary albumin excretion rate diminished from 1447 to 613 μg/min (P < 0.005), and GFR declined from 96 to 89 ml/min/1.73 m2 (P < 0.01). A linear relationship between mean blood pressure and the logarithm of the albuminuria was found (r = 0.48, P < 0.01). Arterial hypertension is an early feature of diabetic nephropathy in young insulin-dependent patients. Early and aggressive treatment of that condition decreases albuminuria, probably due to reduced intraglomerular filtration pressure. Whether sustained reduction in arterial blood pressure to near-normal levels during several years also reduces the rate of decline in GFR in diabetic nephropathy remains to be established.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
45 articles.
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