Nephropathy and changes in sodium-lithium countertransport kinetics in type 2 (non-insulin-dependent) diabetes...

Previous studies of erythrocyte sodium-lithium countertransport activity, a putative genetic marker of essential hypertension, in Type I and Type II diabetic patients with nephropathy have given conflicting results. We have found changes in the maximum velocity (Vmax) and sodium-affinity constant (Km) of sodium-lithium countertransport in Type I diabetic patients with diabetic nephropathy. In this study, sodium-lithium countertransport kinetics were measured in Type II diabetic patients with established diabetic nephropathy, matched uncomplicated Type II diabetic patients, non-diabetic patients with nephropathy and healthy control subjects. Mean standard sodium-lithium countertransport activity was not significantly increased in either of the groups of diabetic patients compared with the non-diabetic control groups. The Type II diabetic patients with nephropathy had a significantly reduced km and Vmax compared with the uncomplicated diabetic patients and non-diabetic control group. These kinetic changes are identical to those observed in Type I diabetic nephropathy patients. There are similar underlying changes in the erythrocyte plasma membrane with the development of nephropathy in both Type I and Type II diabetes.