PREVENTION OF DIABETIC NEPHROPATHY IN IDDM

IDDM 中糖尿病肾病的预防

• 批准号: 3239905
• 负责人: W G WALKER
• 金额: $ 20.51万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-09-30 至 1993-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3239905
• 关键词: ACE inhibitors; albuminuria; captopril; cardiovascular disorder diagnosis; clinical trials; diabetes mellitus therapy; diabetic nephropathy; diabetic retinopathy; disease /disorder prevention /control; early diagnosis; glomerular filtration rate; human subject; human therapy evaluation; insulin dependent diabetes mellitus; longitudinal human study; radioimmunoassay; remission /regression; renal failure; urinalysis

This proposal requests support for a clinical study designed to see whether lowering the hyperfiltration that occurs in early insulin dependent diabetes mellitus and inhibition of angiotensin II converting enzyme will reverse microalbuminuria and prevent the progressive decline in glomerular filtration rate that has been documented in other studies of insulin dependent diabetes. We have available 263 cases of insulin dependent diabetes presently in a longitudinal study of the natural history of diabetic retinopathy by the Department of Ophthalmology. Nearly 70 percent of the subjects do not have proteinuria detectable by routine clinical procedures. In these individuals without proteinuria, the rate of microalbuminuria will be characterized by an albumin radioimmunoassay of timed urine collections and those individuals with albumin excretion rates in excess of 15 micrograms/min will be randomized into two groups. One group will be patients with early microalbuminuria (15 to 80 micrograms/min) and the second group will contain those individuals with microalbumin excretion rates ranging between 81 and 250 micrograms of albumin per minutes. No individual with a blood pressure greater than 140/85 or who is receiving antihypertensive therapy will be included. Each of the two groups will be randomized into a treatment group and a control group and the treatment group given converting enzyme inhibitors at a level of 20 mg/day. Microalbumin excretion rates will be measured every three months and glomerular filtration rates every six months and assessment of retinal changes will be made on an annual basis. Observations will be made over a period of three years following initiation of treatment. Outcome variables will be microalbumin excretion rate, change in GFR and change in the severity of retinopathy. This study should provide a direct test of the hypothesis that the hyperprofusion of the glomeruli in early diabetes mellitus play an important pathogenetic role in the production of diabetic nephropathy.

本提案要求支持一项旨在观察的临床研究

项目成果

Morphologic classification of renal disease and the realities of clinical nephrology: do we need a new approach?

肾脏疾病的形态学分类和临床肾脏病学的现实：我们需要新的方法吗？

• 发表时间: 1988
• 期刊: APMIS. Supplementum
• 作者: Solez,K;Racusen,LC;Walker,WG
• 通讯作者: Walker,WG