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Tubular dysfunction in type I diabetes mellitus.

M Miltényi, A Körner, T Tulassay

    Archives of Disease in Childhood
    |October 1, 1985
    PubMed
    Summary

    Diabetic ketoacidosis and poorly controlled type 1 diabetes impair kidney tubular function. This dysfunction, indicated by elevated urinary enzymes and reduced electrolyte reabsorption, may lead to diabetic nephropathy.

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    Area of Science:

    • Nephrology
    • Endocrinology
    • Diabetology

    Background:

    • Diabetic nephropathy is a major complication of diabetes mellitus.
    • Kidney tubular dysfunction is implicated in its development.
    • Diabetic ketoacidosis and poorly controlled type 1 diabetes are significant clinical conditions.

    Purpose of the Study:

    • To investigate kidney tubular function in patients experiencing diabetic ketoacidosis.
    • To assess tubular function in individuals with poorly controlled type 1 diabetes.
    • To explore the potential link between tubular dysfunction and diabetic nephropathy.

    Main Methods:

    • Measurement of urinary beta 2 microglobulin and enzyme activities (gamma glutamyltransferase, leucine aminopeptidase, N-acetyl-beta-D-glucosaminidase) in patients with diabetic ketoacidosis compared to controls.
    • Assessment of tubular electrolyte transport, specifically phosphate and sodium reabsorption, in patients with poorly controlled type 1 diabetes.

    Main Results:

    • Significantly elevated urinary excretion of beta 2 microglobulin and specific enzymes in patients during diabetic ketoacidosis.
    • Significant reduction in tubular phosphate and sodium reabsorption in poorly controlled type 1 diabetics.
    • Evidence of tubular dysfunction in both patient groups.

    Conclusions:

    • Diabetic ketoacidosis is associated with acute tubular dysfunction.
    • Poorly controlled type 1 diabetes leads to impaired tubular electrolyte transport.
    • These tubular dysfunctions may be contributing factors to the pathogenesis of diabetic nephropathy.

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