Low glomerular filtration rate in normoalbuminuric type 1 dihibetic patients - An indicator of more advanced glomerular lesions
Low glomerular filtration rate in normoalbuminuric type 1 dihibetic patients - An indicator of more advanced glomerular lesions
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DOI：
10.2337/diabetes.52.4.1036
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发表时间：
2003-04-01
期刊：
影响因子：
7.7
通讯作者：
Mauer, M
中科院分区：
文献类型：
--
作者：
Caramori, ML;Fioretto, P;Mauer, M
尿白蛋白排泄率增加被广泛认为是糖尿病的第一个临床体征。肾病然而，一些糖尿病患者可能首先表现出肾小球滤过率（GFR）降低或高血压。相对晚期的糖尿病肾脏病变可存在于一些长期正常白蛋白尿的糖尿病患者中，这可能表明进展为微量白蛋白尿，然后发展为明显的糖尿病肾病的风险增加。本研究的目的是确定一组低GFR的血白蛋白尿1型糖尿病患者，并将其与GFR正常的正常白蛋白尿患者进行比较。总共有105例正常白蛋白尿的I型糖尿病患者，至少有10年的糖尿病病程，进行了肾活检的研究目的。根据GFR将患者分为正常组（大于或等于90 ml（.）min（-1）（.）1.73 m（-2））或减少（<90 ml（.）min（-1）（.）1.73 m（-2））GFR。临床和肾脏结构参数。比较两组间的差异。肾小球结构参数通过电子显微镜形态计量学估计。23例GFR降低的患者有更多的晚期糖尿病肾小球军团。女性患者中GFR降低更为常见，特别是如果还存在视网膜病变和/或高血压。本报告证实，GFR降低，发生在长期正常白蛋白尿的1型糖尿病患者，并与更先进的糖尿病肾小球病变，并可能与进展的风险增加。因此，我们建议对长期尿蛋白正常的1型糖尿病女性患者，尤其是伴有视网膜病变或高血压的患者，定期测量GFR。
Increased urinary albumin excretion rate is widely accepted as the first clinical sign of diabetic. nephropathy. However, it is possible that some diabetic patients could first manifest reduced glomerular filtration rate (GFR) or hypertension. Relatively advanced diabetic renal lesions can be present in some diabetic patients with long-standing normoalbuminuria, and this might indicate increased risk of progression to microalbuminuria and then to overt diabetic nephropathy. The aim of this study was to identify A group of hormoalbuminuric type 1 diabetic patients with low GFR and compare them with normoalbuminuric patients with normal GFR. Altogether, 105 normoalbuminuric type I diabetic patients with at least 10 years of diabetes duration that had a renal biopsy performed for research purposes were studied. Patients were divided according to GFR into groups with normal ( greater than or equal to90 ml (.) min(-1) (.) 1.73 m(-2)) or reduced ( < 90 ml (.) min(-1) (.) 1.73 m(-2)) GFR. Clinical and renal structural parameters. were compared between these two groups. Glomerular structural parameters were estimated by electron microscopic morphometry. The 23 patients with reduced, GFR had more advanced diabetic glomerular legions. The finding of reduced GFR wag much more common among female patients, particularly if retinopathy and/or hypertension were also present. This report confirms that reduced GFR, occurs among long-standing normoalbiuminuric type 1 diabetic patients and is associated with more advanced diabetic glomerular lesions and, probably, with increased risk of progression. For there reasons, we suggest that regular measurements, of GFR be performed in long standing normoalbuminuric type 1 diabietic female diabetic patients, especially in those with retinopathy or hypertension.