| Clinical and histological correlations of decline in renal function in diabetic patients with proteinuria. | |
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MedLine Citation:
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PMID: 8039599 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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J L Taft; C J Nolan; S P Yeung; T D Hewitson; F I Martin |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Diabetes Volume: 43 ISSN: 0012-1797 ISO Abbreviation: Diabetes Publication Date: 1994 Aug |
Date Detail:
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Created Date: 1994-08-22 Completed Date: 1994-08-22 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372763 Medline TA: Diabetes Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1046-51 Citation Subset: AIM; IM |
Affiliation:
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Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged 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 Humans Hypertension / drug therapy, etiology Kidney / blood supply, pathology, physiopathology* Kidney Glomerulus / pathology Metabolic Clearance Rate Middle Aged Proteinuria / pathology, physiopathology* |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 60-27-5/Creatinine; 75847-73-3/Enalapril |
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