Urinary excretion of retinol-binding protein in type 1 (insulin-dependent) diabetic patients with microalbuminuria and clinical diabetic nephropathy

1992 ◽  
Vol 28 (3-4) ◽  
pp. 206-210 ◽  
Author(s):  
P. Pontuch ◽  
T. Jensen ◽  
T. Deckert ◽  
P. Ondrejka ◽  
M. Mikulecky
Keyword(s):  
Diabetic Nephropathy ◽  
Urinary Excretion ◽  
Binding Protein ◽  
Retinol Binding Protein ◽  
Diabetic Patients ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic

Effect of Posture and Acute Glycaemic Control on the Excretion of Retinol-Binding Protein in Normoalbuminuric Insulin-Dependent Diabetic Patients

1993 ◽  
Vol 84 (4) ◽  
pp. 461-467 ◽  
Author(s):  
Carlo Catalano ◽  
Peter H. Winocour ◽  
Susan Gillespie ◽  
Ian Gibb ◽  
K. George M. M. Alberti
Keyword(s):  
Blood Glucose Concentration ◽  
Excretion Rate ◽  
Binding Protein ◽  
Insulin Dependent Diabetes ◽  
Retinol Binding Protein ◽  
Diabetic Patients ◽  
Control Subjects ◽  
Protein Excretion ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic

1. It has been suggested that tubular damage may precede gomerular damage at the onset of diabetic nephropathy. This may be reflected by increased urinary excretion of low-molecular-mass proteins, such as retinol-binding protein. 2. We have measured the urinary excretion rate of retinol-binding protein overnight, during orthostasis and during a hyperinsulinaemic euglycaemic clamp (blood glucose concentration 7.0 mmol/l) with stable diuresis in 34 normotensive, normoalbuminuric insulin-dependent diabetic patients and in 10 normal control subjects. Normal control subjects were not clamped. A further four normoalbuminuric insulin-dependent diabetic patients were rendered euglycaemic without a water load. 3. Overnight retinol-binding protein excretion rate was 58 (16-157) [median(range)] ng/min in patients with insulin-dependent diabetes and 32 (15-72) ng/min in control subjects (P < 0.01). The excretion rate did not change during orthostasis [patients with insulin-dependent diabetes, 67 (3-173) ng/min; control subjects, 23 (5-78) ng/min]. During the euglycaemic clamp retinol-binding protein excretion rate increased to 383 (78-4897) ng/min in patients with insulin-dependent diabetes (P < 0.01). An average increment in retinol-binding protein excretion rate of greater than 4000% was noted after acute euglycaemia in those patients with insulin-dependent diabetes who were not water-loaded. 4. In insulin-dependent diabetes, both overnight and orthostatic retinal-binding protein excretion was not correlated with fasting blood glucose concentration, HbA1, fructosamine or duration of diabetes. The absolute and incremental excretion rates of retinol-binding protein during the clamp were, however, correlated with both fasting blood glucose concentration and glucose excretion rate (rs = 0.41-0.48, P < 0.01). 5. The study demonstrates that retinol-binding protein excretion is increased in insulin-dependent diabetes in the absence of microalbuminuria and that this increase in retinol-binding protein excretion is particularly pronounced after acute euglycaemia. Acute tubular dysfunction related to acute changes in glucose control appears to be the most likely explanation, but established tubular damage could also be implicated. Postural variation in retinol-binding protein excretion was not detected.

Glomerular and Tubular Proteinuria in Type 1 (Insulin-Dependent) Diabetic Patients with and without Retinopathy

1992 ◽  
Vol 29 (3) ◽  
pp. 265-270 ◽  
Author(s):  
P Martin ◽  
H Tindall ◽  
J N Harvey ◽  
T M Handley ◽  
C Chapman ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Diabetic Patients ◽  
Tubular Proteinuria ◽  
Duration Of Diabetes ◽  
Albumin Excretion ◽  
Potential Index ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Prospective Longitudinal

We compared the urinary excretion of albumin, transferrin, N-acetyl-β-D-glucosaminidase and α-1-microglobulin in 78 Type 1 (insulin-dependent) diabetic patients: 39 with retinopathy and 39 without. The two groups were matched for age, sex and duration of diabetes. The patients with retinopathy had increased excretion (median and range) of albumin [1·7 (0·3–399·1) versus 1·0 (0·3–116·6) mg/mmol creatinine, P < 0·05], transferrin [114·2 (4·1–37126·2) versus 33·4 (1·0–4176·7) μg/mmol creatinine, P < 0·01] and N-acetyl-β-D-glucosaminidase [23·8 (1·1–119·1) versus 15·0 (0·1–65·1) μmol/h/mmol creatinine, P < 0·05] but not α-1-microglobulin. Transferrin excretion correlated with albumin excretion. The prevalence of increased transferrin excretion (transferrinuria) was greater than that of microalbuminuria in patients both with and without retinopathy ( P < 0·01 in both cases). Urinary transferrin seems likely to be predominantly of glomerular origin and merits prospective longitudinal evaluation as a potential index of the microangiopathic process.

scholarly journals Effects of acetazolamide on kidney function in Type 1 (insulin-dependent) diabetic patients with diabetic nephropathy

Diabetologia ◽  
1988 ◽  
Vol 31 (11) ◽  
Author(s):  
P. Sk�tt ◽  
E. Hommel ◽  
N.E. Bruun ◽  
S. Arnold-Larsen ◽  
H.-H. Parving
Keyword(s):  
Diabetic Nephropathy ◽  
Kidney Function ◽  
Diabetic Patients ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic

Low-molecular-mass proteinuria as a marker of proximal renal tubular dysfunction in normo- and microalbuminuric non-insulin-dependent diabetic subjects

1993 ◽  
Vol 39 (3) ◽  
pp. 517-519 ◽  
Author(s):  
J Holm ◽  
L Hemmingsen ◽  
N V Nielsen
Keyword(s):  
Urinary Excretion ◽  
Molecular Mass ◽  
Normal Serum ◽  
Retinol Binding Protein ◽  
Diabetic Patients ◽  
Tubular Dysfunction ◽  
Renal Tubular Dysfunction ◽  
Protein Marker ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic

Abstract We determined the urinary excretion, expressed as the protein/creatinine ratio (morning urines), of albumin (a marker of glomerular dysfunction) and retinol-binding protein (RBP; a low-molecular-mass protein marker of tubular proteinuria) in 102 non-insulin-dependent diabetic patients. There was a statistically significant (P &lt; 0.0001) correlation (rho = 0.38) between the urinary excretion values of the two proteins. The population could be divided into four subgroups: 32 with normal excretion values, 15 with above-normal urinary excretion of RBP, 24 with above-normal urinary excretion of albumin, and 31 patients with above-normal urinary excretion of both proteins. No patients had above-normal serum creatinine concentrations or above-normal serum RBP concentrations. This seems to exclude "tubular overflow proteinuria" as the cause of the increased urinary excretion of RBP seen in some patients with non-insulin-dependent diabetes. Our data suggest the presence of a state of proximal tubular dysfunction in these patients.

scholarly journals Glucose-induced changes in renal haemodynamics in proteinuric Type 1 (insulin-dependent) diabetic patients: inhibition by acetylsalicilic acid infusion

Diabetologia ◽  
1993 ◽  
Vol 36 (7) ◽  
pp. 622-627 ◽  
Author(s):  
S. De Cosmo ◽  
K. Earle ◽  
A. Morocutti ◽  
J. Walker ◽  
P. Ruggenenti ◽  
...  
Keyword(s):  
Renal Haemodynamics ◽  
Diabetic Patients ◽  
Acid Infusion ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Induced Changes
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