Document Detail


Charge selectivity of proteinuria in type I diabetes explored by Ig subclass clearance.
MedLine Citation:
PMID:  1756909     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To investigate the role of protein charge in early diabetic proteinuria, the clearance of proteins differing in charge and/or size (anionic and cationic Igs, albumin) was evaluated in 98 insulin-dependent (type I) diabetic patients selected as a representative sample of the 418 patients attending our clinics. Of the patients, 12.9% were microalbuminuric and 4.8% were macroalbuminuric. Anionic and total IgG clearances were significantly increased in 30.6 and 12.2% of patients and were correlated with duration of disease. Anionic IgG4 clearances were increased in patients (9.2%) with normal IgG excretion, suggesting that charge-selectivity impairment is responsible for protein loss. Anionic Ig clearances were also higher in some patients (14.3%) with normal albumin clearance, probably as a result of different glomerular filtration and/or tubular reabsorption. The anionic-cationic IgG clearance ratio tended to increase in parallel with albumin clearance, but once above macroalbuminuric levels, it tended to fall again, indicating the concomitant presence of size-selectivity loss. The anionic IgG clearance and the anionic-cationic IgG ratio, in addition to albumin excretion, may be valuable in assessing early kidney protein charge-selectivity impairment and better characterizing normoalbuminuric patients and those in the preclinical stage of diabetic nephropathy.
Authors:
P Pietravalle; S Morano; G Cristina; M G De Rossi; G Mariani; P Cotroneo; G Ghirlanda; A Clementi; D Andreani; U Di Mario
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetes     Volume:  40     ISSN:  0012-1797     ISO Abbreviation:  Diabetes     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-02-03     Completed Date:  1992-02-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372763     Medline TA:  Diabetes     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1685-90     Citation Subset:  AIM; IM    
Affiliation:
Department of Endocrinology, University La Sapienza, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Albuminuria*
Biological Markers / urine
Diabetes Mellitus, Type 1 / immunology,  physiopathology,  urine*
Diabetic Nephropathies / diagnosis
Follow-Up Studies
Glomerular Filtration Rate
Humans
Immunoglobulin G / classification,  urine*
Metabolic Clearance Rate
Models, Statistical
Proteinuria*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Immunoglobulin G

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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