Document Detail

Clinical and histological correlations of decline in renal function in diabetic patients with proteinuria.
MedLine Citation:
PMID:  8039599     Owner:  NLM     Status:  MEDLINE    
In 47 patients with diabetic nephropathy (29 type I, 18 type II) renal function and blood pressure (BP) (treated with or without an angiotensin-converting enzyme [ACE] inhibitor, enalapril [10 mg], in 38 hypertensive patients) were followed over 4 years. A percutaneous renal biopsy was performed in all patients initially and repeated in a representative 19 patients with treated hypertension after 4 years. Mean glomerular volume (MGV), interstitial fibrosis (IF), capillary volume, and sclerosed glomeruli (GS) were measured histomorphometrically. Mean fall in creatinine clearance (CCr) was 11.8% after 4 years with no difference between treatment groups or type of diabetes. BP both initially and during treatment correlated with initial and final serum creatinine and CCr (P < 0.01). There were no histomorphometric differences between type I and type II patients or hypertension treatment groups. Initial IF correlated with initial and final serum creatinine and CCr (P < 0.05) in all patients and type I patients alone, MGV correlated inversely with CCr in type I patients (P < 0.05). After 4 years, IF (24.8 vs. 30.0%, P < 0.01) and GS (26 vs. 37%, P < 0.05) increased significantly, and increase in IF correlated with fall in CCr (P < 0.01). Proteinuria and HbA1 did not correlate with indexes of function or structure. In this longitudinal study of patients with diabetic nephropathy, there was a close relation between BP and renal function but no difference between treatment with enalapril and other hypertensive agents. The correlations between renal function and histology at entry and after 4 years suggest that IF is a co-determinant of renal function in diabetic nephropathy.
J L Taft; C J Nolan; S P Yeung; T D Hewitson; F I Martin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetes     Volume:  43     ISSN:  0012-1797     ISO Abbreviation:  Diabetes     Publication Date:  1994 Aug 
Date Detail:
Created Date:  1994-08-22     Completed Date:  1994-08-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372763     Medline TA:  Diabetes     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1046-51     Citation Subset:  AIM; IM    
Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
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MeSH Terms
Blood Glucose / metabolism
Capillaries / pathology
Creatinine / blood,  urine
Diabetes Mellitus, Type 1 / complications,  pathology,  physiopathology*
Diabetes Mellitus, Type 2 / complications,  pathology,  physiopathology*
Diabetic Nephropathies / pathology,  physiopathology*
Enalapril / therapeutic use
Hemoglobin A, Glycosylated / metabolism
Hypertension / drug therapy,  etiology
Kidney / blood supply,  pathology,  physiopathology*
Kidney Glomerulus / pathology
Metabolic Clearance Rate
Middle Aged
Proteinuria / pathology,  physiopathology*
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 60-27-5/Creatinine; 75847-73-3/Enalapril

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

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