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Related Experiment Videos

Renal functional reserve in IDDM patients

H Sackmann1, T Tran-Van, I Tack

  • 1Service d'Endocrinologie-Diabétologie, Rangueil University Hospital, Toulouse, France.

Diabetologia
|March 14, 1998
PubMed
Summary

Renal functional reserve (RFR) is altered in insulin-dependent diabetes mellitus (IDDM) patients. Early and advanced IDDM stages show impaired RFR, while incipient nephropathy maintains normal RFR, indicating complex changes in kidney function.

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Area of Science:

  • Nephrology
  • Endocrinology
  • Diabetology

Background:

  • Diabetic nephropathy is a major complication of insulin-dependent diabetes mellitus (IDDM).
  • Assessing renal functional reserve (RFR) can reveal early kidney dysfunction.
  • The relationship between RFR and the stage of diabetic nephropathy requires further elucidation.

Purpose of the Study:

  • To investigate alterations in renal functional reserve (RFR) in patients with insulin-dependent diabetes mellitus (IDDM).
  • To correlate RFR changes with the specific stage of diabetic nephropathy, including normoalbuminuria, microalbuminuria, and macroalbuminuria with hypertension.

Main Methods:

  • Evaluated RFR in 33 IDDM patients and 12 healthy controls over eight 1-hour clearance periods.
  • Stimulated glomerular filtration rate (GFR) using a 3-hour amino acid infusion.

Related Experiment Videos

  • Calculated RFR as the difference between stimulated and baseline GFR.

    • Main Results:

    • Early normotensive diabetic patients (normal albuminuria) had higher baseline GFR but lower RFR compared to controls.
    • Normotensive patients with microalbuminuria showed similar baseline GFR and RFR to controls.
    • Macroalbuminuric hypertensive patients exhibited lower baseline GFR and non-significant RFR, with impaired renal vascular resistance response.

    Conclusions:

    • Microalbuminuric normotensive patients maintain a normal RFR.
    • RFR is reduced in early IDDM with hyperfiltration and in advanced IDDM with hypertension and decreased GFR.
    • These findings suggest permanent glomerular hyperfiltration in early IDDM and overt nephropathy, but not in incipient nephropathy.