| | |  | | | | Record from Web of Science® | | | | | | |
| GLOMERULAR FUNCTION IN PIMA-INDIANS WITH NONINSULIN-DEPENDENT DIABETES-MELLITUS OF RECENT ONSET |
|
|
| Author(s): MYERS BD, NELSON RG, WILLIAMS GW, BENNETT PH, HARDY SA, BERG RL, LOON N, KNOWLER WC, MITCH WE |
| Source: JOURNAL OF CLINICAL INVESTIGATION Volume: 88 Issue: 2 Pages: 524-530 Published: AUG 1991 |
| Times Cited: 101 References: 39 |
| Abstract: Differential solute clearances were used to characterize glomerular function in 20 Pima Indians with noninsulin-dependent diabetes mellitus (NIDDM) of < 3 yr duration. 28 Pima Indians with normal glucose tolerance served as controls. In the diabetic group, the glomerular filtration rate (GFR, iothalamate clearance) exceeded the control value by 15% (140 +/- 6 vs. 122 +/- 5 ml/min, P < 0.01). A corresponding 12% increase in renal plasma flow (RPF) was not statistically significant and did not account fully for the observed hyperfiltration, suggesting a concomitant elevation of the ultrafiltration pressure or coefficient. The median albumin excretion ratio in NIDDM exceeded control by almost twofold (10.1 vs. 5.8 mg/g creatinine), a trend which just failed to achieve statistical significance (P = 0.06). Fractional clearances of dextrans of broad size distribution were also elevated in diabetic subjects, significantly so for larger dextrans of between 48 and 60 angstrom radius. A theoretical analysis of dextran transport through a heteroporous membrane revealed glomerular pores in NIDDM to be uniformly shifted towards pores of larger size than in controls. We conclude that an impairment of barrier size selectivity combined with high GFR elevates the filtered protein load in NIDDM of recent onset. We propose that enhanced transglomerular trafficking of protein may predispose to sclerosis of glomeruli in those Pima Indians with NIDDM who ultimately develop diabetic nephropathy. |
| Document Type: Article |
| Language: English |
| Reprint Address: MYERS, BD (reprint author), STANFORD UNIV, MED CTR, SCH MED, DIV NEPHROL, ROOM S215, STANFORD, CA 94305 USA |
Addresses:
1. CLEVELAND CLIN FDN, CLEVELAND, OH 44195 USA
2. EMORY UNIV, SCH MED, DIV RENAL, ATLANTA, GA 30322 USA
3. NIDDKD, PHOENIX EPIDEMIOL & CLIN RES BRANCH, PHOENIX, AZ 85014 USA
4. CLEVELAND CLIN FDN, DEPT BIOSTAT & EPIDEMIOL, PHOENIX, AZ 85016 USA |
| Publisher: ROCKEFELLER UNIV PRESS, 222 E 70TH STREET, NEW YORK, NY 10021 |
| Subject Category: Medicine, Research & Experimental |
| IDS Number: GA276 |
| ISSN: 0021-9738 |
|
| | | | | | | | | Record from Web of Science® | | | | | | | | | |