Document Detail

Progression of diabetic nephropathy in normotensive type 1 diabetic patients.
MedLine Citation:
PMID:  10412749     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The first aim of our long-term study was to describe the natural history of diabetic nephropathy in 59 normotensive type 1 diabetic patients. Secondly, we evaluated genetic and nongenetic progression promoters. METHODS: The following progression promoters were determined: the insertion/deletion polymorphism in the angiotensin converting enzyme (ACE) gene, blood pressure, albuminuria, hemoglobin A1c, cholesterol, smoking, height, and gender. We studied the natural history by measuring 51Cr-EDTA plasma clearance at yearly intervals at least three times during [median (range)] 5.5 (2.2 to 18.3) years. RESULTS: At baseline the three groups (II, N = 11; ID, N = 25, and DD, N = 23) had comparable GFR (103 +/- 16; 99 +/- 19; 113 +/- 22 ml/min/1.73 m2, respectively; mean +/- SD), arterial blood pressure, albuminuria, and hemoglobin A1c. During the follow-up there was a median rate of decline in GFR in all 59 patients of 1.2 (range 12.9 to -4.4) ml/min/year. During the study period no significant differences were observed in: the rate of decline in glomerular filtration rate [median (range) 0.9 (10.6 to -1.9); 2.5 (12.9 to -4.4); 1.4 (10.8 to -1.9 ml/min/year)], arterial blood pressure, albuminuria, hemoglobin A1c or cholesterol between the three groups (II, ID and DD), respectively. At baseline, multiple linear regression analysis including the above-mentioned putative risk factors revealed that albuminuria, short stature, and male gender independently predict an enhanced decline in GFR [R2 (adjusted) = 0.33; P < 0.002]. During the follow-up period, only albuminuria acted as an independent progression promoter [R2 (adjusted) = 0.37; P < 0.0001]. CONCLUSIONS: Our study revealed a rather slow progression of kidney disease in normotensive type 1 diabetic patients with diabetic nephropathy. Albuminuria, short stature, and male gender act as progression promoters in such patients.
P Jacobsen; K Rossing; L Tarnow; P Rossing; C Mallet; O Poirier; F Cambien; H H Parving
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kidney international. Supplement     Volume:  71     ISSN:  0098-6577     ISO Abbreviation:  Kidney Int. Suppl.     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-09-15     Completed Date:  1999-09-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7508622     Medline TA:  Kidney Int Suppl     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S101-5     Citation Subset:  IM    
Steno Diabetes Center, Gentofte, Denmark.
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MeSH Terms
Albuminuria / urine
Blood Pressure
Cholesterol / blood
Diabetes Mellitus, Type 1 / complications*
Diabetic Nephropathies / complications,  genetics,  pathology*
Disease Progression
Follow-Up Studies
Glomerular Filtration Rate
Hemoglobin A, Glycosylated / metabolism
Hypertension / complications
Regression Analysis
Reg. No./Substance:
0/Hemoglobin A, Glycosylated; 57-88-5/Cholesterol

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

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