scholarly journals ASSESSMENT OF NEPHRIN AND PODOCIN LEVELS IN THE URINE OF PATIENTS WITH DIABETES MELLITUS

2017 ◽  
Vol 21 (2) ◽  
pp. 33-40
Author(s):  
I. N. Bobkova ◽  
A. A. Shchukina ◽  
M. V. Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Arterial Hypertension ◽  
Healthy Subjects ◽  
Early Diagnostics ◽  
Urinary Levels ◽  
Patients With Diabetes ◽  
Early Diabetic Nephropathy

THE AIM:to assess excretion value of podocytes injury biomarkers in urine and to clarify their significance for early diabetic nephropathy (DN) diagnostics in diabetes mellitus (DM) patients with different severity of albuminuria (AU)/proteinuria(PU).PATIENTS AND METHODS.74 DM pts were studied, including 30 with type1 DM (T1DM) and 44 pts with type2 DM (T2DM). They were divided into three groups: 41 pts with AU <30 mg/gCr (A1), 13 pts with AU 30-300 mg/gCr (A2), 20 pts with PU (A3). CKD S1 was revealed in 41pts, CKD S2 – in 25 pts, CKD S3 – in 8 pts. Arterial hypertension was observed in 52 pts of 74(70%), mainly in T2DM. 10 healthy subjects were studied as control. Urinary levels of nephrin and podocin (an important slit diaphragm proteins) were measured by ELISA.RESULTS.Nephrinuria (NU) >5,84ng/ml/g, which not detecting in controls, was revealed in 63% of A1 pts, in 77% – in A2, in 80% – in A3. Podocinuria (PdU)>1,73ng/ml/g was revealed in 78% of A1 pts, in 54% of A2 and in 83% – A3. NU in pts with PU was significantly higher than in AU<30 mg/g. PDU in groups with different AU/PU was equally high and has no differ between DM types. Direct correlation was obtained between NU and AU (R=0,947 p<0,05). NU and PdU in T1DM correlated directly with serum creatinine (R=0,489 p<0,05 and R=0,468 p<0,05) and indirectly with GFR (R=-0,461 p<0,05 and R=-0,36 р<0,05). In DM duration less than 5 years NU directly correlated with НbА1с level, in T2DM – indirectly with systolic blood pressure.CONCLUSON. Nephrin and podocin levels can be useful for early diagnostics and monitoring of DN. 

scholarly journals PREVALENCE OF NEPHROPATHY AND ITS PARAMETERS IN PATIENTS WITH DIABETES MELLITUS- A PROSPECTIVE STUDY IN A CENTRAL INDIAN POPULATION

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Suresh Kumar Sethi ◽  
Rajesh Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Diabetic Patients ◽  
Early Screening ◽  
Patients With Diabetes ◽  
Mdrd Formula ◽  
A Prospective Study

Background: Hyperglycemia is an important risk factor for the development of diabetic nephropathy. In the initial stages ie micro albuminuria the DKD is clinically detectable and can even be reversed. Hence early screening of diabetic patients is important. Hence the aim of this study was to evaluate the prevalence of nephropathy in a cross section of diabetic patients. Objectives: The Aim of our study was to evaluate the prevalence of nephropathy in recently detected diabetic patients by evaluating microalbuminuria, serum creatinine and creatinine clearance. Methods: A total of 120 patients above 18 years were included in the study and were divided into three groups according to age and were further divided into three groups as per the duration of diseases Patients were again divided into two groups according to the gender. The GFR was calculated as per the MDRD formula and the patients were divided further as per the stage of CKD. Serum Creatinine levels were calculated and the variables associated with CKD were adjusted by Logistic Regression. Results: Our results suggests that 41.25% of subjects were in mild to severe nephropathy out of which 16.25 % were within the three years of diagnosis, thus suggesting the role of early and routine investigation in diabetic patients. Conclusion: Hence the role of life style is clearly emphasized by our results. Although when the variables were adjusted with the logistic regression the occupation was not that significant. Keywords: Albuminuria, Diabetes mellitus (DM), Diabetic Kidney Disease (DKD), Diabetic nephropathy (DN), Serum Creatinine.

scholarly journals PREVALENCE OF NEPHROPATHY AND ITS PARAMETERS IN PATIENTS WITH DIABETES MELLITUS- A PROSPECTIVE STUDY IN A CENTRAL INDIAN POPULATION

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Suresh Kumar Sethi ◽  
Rajesh Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Diabetic Patients ◽  
Early Screening ◽  
Patients With Diabetes ◽  
Mdrd Formula ◽  
A Prospective Study

Background: Hyperglycemia is an important risk factor for the development of diabetic nephropathy. In the initial stages ie micro albuminuria the DKD is clinically detectable and can even be reversed. Hence early screening of diabetic patients is important. Hence the aim of this study was to evaluate the prevalence of nephropathy in a cross section of diabetic patients. Objectives: The Aim of our study was to evaluate the prevalence of nephropathy in recently detected diabetic patients by evaluating microalbuminuria, serum creatinine and creatinine clearance. Methods: A total of 120 patients above 18 years were included in the study and were divided into three groups according to age and were further divided into three groups as per the duration of diseases Patients were again divided into two groups according to the gender. The GFR was calculated as per the MDRD formula and the patients were divided further as per the stage of CKD. Serum Creatinine levels were calculated and the variables associated with CKD were adjusted by Logistic Regression. Results: Our results suggests that 41.25% of subjects were in mild to severe nephropathy out of which 16.25 % were within the three years of diagnosis, thus suggesting the role of early and routine investigation in diabetic patients. Conclusion: Hence the role of life style is clearly emphasized by our results. Although when the variables were adjusted with the logistic regression the occupation was not that significant. Keywords: Albuminuria, Diabetes mellitus (DM), Diabetic Kidney Disease (DKD), Diabetic nephropathy (DN), Serum Creatinine.

scholarly journals Risk factors for the development of diabetic nephropathy

2009 ◽  
Vol 137 (1-2) ◽  
pp. 18-26 ◽  
Author(s):  
Miodrag Antic ◽  
Aleksandra Jotic ◽  
Milan Radovic ◽  
Jelena Seferovic ◽  
Nebojsa Lalic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Diabetic Nephropathy ◽  
Kidney Function ◽  
Kidney Volume ◽  
Factors Associated ◽  
Patients With Diabetes ◽  
Dm Type 2

Introduction. Results of epidemiological analysis show that one third of patients with diabetes mellitus develop diabetic nephropathy (DN). Strategies used until now to slow down the progression of DN were initiated when the symptoms of DN were already present. Objective. Our objective was to analyze the prevalence and characteristics of DN and to determine the factors leading to DN. Methods. Fifty-two patients with diabetes mellitus (DM) - 32 with type 1 aged 32 years and 20 with type 2 aged 59 years - were referred from the Institute of Endocrinology, Diabetes and Metabolic Diseases to the Department of Nephrology for kidney function evaluation. Apart from routine laboratory analyses, glomerular filtration rate was calculated using the MDRD formula (modification of diet in renal disease), the size of the kidney was measured by ultrasound, and kidney volume was calculated using the ellipsoid formula. Results Thirty percent of the patients revealed normal (eight patients with DM type 1) or satisfactory kidney function (eight patients with DM type 1) with physiological proteinuria. Micro-albuminuria (MAU) or pathological proteinuria (PRT) were found in 10 and 9 patients, respectively, with DM type 1, while decreased kidney function was found in one patient without proteinuria. MAU or PRT were found in four and eight patients, respectively, with DM type 2 and decreased kidney function in four patients without proteinuria. Kidney function was significantly lower in patients with DM type 2 in comparison to DM type 1, while the patients with decreased kidney function had a higher PRT. Compared to DM type 2, in DM type 1 patients, the kidney was longer, and parenchymal artery resistance index was lower in DM type 1 patients compared to DM type 2. Factors associated with DN were patient's age, duration of diabetes, systolic blood pressure, HbA1c and kidney volume. Conclusion. The prevalence of DN among the studied patients was 70%. Treatable factors associated with the development of DN are strict control of blood pressure and glycaemia control.

scholarly journals Structural, functional and endothelial peculiarities of diabetic nephropathy in patients with arterial hypertension

2018 ◽  
pp. 13-17
Author(s):  
О. M. Chernatska ◽  
N. V. Demikhova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Arterial Hypertension ◽  
Glycosylated Hemoglobin ◽  
Albumin Excretion Rate ◽  
Endothelin 1 ◽  
Patients With Diabetes

The aim of our one-stage observational study was the detail analysis of structural, functional, endothelial peculiarities of diabetic nephropathy in patients with coexistent arterial hypertension. Methods. Our study involved 96people with arterial hypertension and type 2 diabetes mellitus (I group), 25 patients with arterial hypertension (II group), 15 practically healthy persons (III group) treated and obtained in Sumy City Clinical Hospital №1. Cardiovascular complications were determined in all patients from I and II groups. The average age of the patients was 62.31 ± 0.2 years. The level of glycosylated hemoglobin (HbAlc) was determined by the biochemical method, albuminuria by immunoassay. The level of endothelin-1 (ET-1) in serum was studied using ELISA. Results. It was found that the level of ET-1 was significantly higher in patients with diabetes compared with only hypertensive patients. In the patients with urine albumin excretion rate category A2 the level of endothelin-1 was significantly higher compared with the category A1 patients and less compared with category A3 patients (11.42 ± 49 vs 25 ± 0.57pg/ml, p = 0.0329 and 11.42 ± 0.49 vs 2.25 ± 1.04pg/ml, p <0.0001, respectively. So, the level of ET-1 increased in proportion to albuminuria. In patients with the albuminuria category A2, the endothelin-1 level was higher than in subjects with the A1 category and lower than in patients with the A3 category. In addition, we identified a moderate direct correlation between the blood level of ET-1 in the patients with diabetes and blood glucose level (r = 0.29;p = 0.004). Conclusion. Finally, it is the confirmation of greater endothelial function disorders for arterial hypertension and type 2 diabetes mellitus. In conclusion, endothelial dysfunction promotes diabetic nephropathy progression.

scholarly journals COEXISTANCE OF DIABETES MELLITUS AND THYROID DISORDERS: A VIEW ON DYSFUNCTION OF THE ENDOCRINE SYSTEM

2018 ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Glycemic Control ◽  
Arterial Hypertension ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Endocrine System ◽  
Thyroid Disorders ◽  
Adequate Therapy ◽  
Patients With Diabetes

Thyroid disorders in patients with diabetes mellitus were studied in 196 patients, divided into 4 main groups (hyperthyroidism in patients with diabetes, hypothyroidism in patients with diabetes, euthyroidism in patients with diabetes and diabetes patients without any thyroid pathology). It was found that diabetes and thyroid disorders have been shown mutually influence on each other and proved associations between both conditions. Compensation of thyroid function due to adequate therapy leads to controlled hyperglycemia, positive arterial hypertension disease mode and better diabetes mellitus outcome. Diabetes and thyroid disorders have been shown to mutually influence each other and associations between both conditions have long been reported. Compensation of thyroid function due to adequate therapy leads to controlled hyperglycemia, less frequency of DM and better DM outcome2.Hyperthyroidism as hypothyroidism impairs glycemic control in diabetic subjects, but hypothyroidism patients alter carbohydrate metabolism with inability to gain stable com-pensation of DM compering with euthyroidism and DM without thyroid dysfunction.3.Despite increased levels of BP, both systolic and diastolic, in patients with hypothyroidism group, prevalence of AH 3rdstage and AH complications were significantly higher in hyperthyroidism which requires more strict control of blood pressure levels and AH treatment in this group of patients.

scholarly journals Current Guidelines for the Treatment of Arterial Hypertension in Patients with Diabetes Mellitus and Chronic Kidney Disease

2021 ◽  
Vol 17 (2) ◽  
pp. 323-331
Author(s):  
T. Yu. Demidova ◽  
O. A. Kislyak
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Enzyme Inhibitor ◽  
Angiotensin Ii Receptor Blocker ◽  
Prevention And Treatment ◽  
Patients With Diabetes

The current understanding of the management of patients with diabetes mellitus (DM) based on the concept of the cardiovascular continuum involves not only the prevention and treatment of cardiovascular diseases (CVD), but also the prevention and treatment of chronic kidney disease (CKD). The fact is that patients with DM and CKD represent a special group of patients with a very high risk of CVD and cardiovascular mortality. Such patients require early diagnosis and timely identification of risk factors for the development and progression of CKD for their adequate correction. Arterial hypertension, along with hyperglycemia, is the main risk factor for the development and progression of CKD in patients with diabetes. In this regard, the choice of antihypertensive therapy (AHT) in patients with diabetes is of particular importance. The basis of AHT in diabetes and CKD is the combination of a blocker of the renin-angiotensin-aldosterone system (an angiotensin-converting enzyme inhibitor [ACE inhibitor] or an angiotensin II receptor blocker [ARB]) and a calcium channel blocker (CCB) or a thiazide / thiazide-like diuretic. The task of the performed AHT is to achieve the target level of blood pressure (BP). At the same time, the optimal blood pressure values in patients with diabetes and CKD are blood pressure values in the range of 130-139/70-79 mm Hg. If the target blood pressure is not achieved, it is necessary to intensify antihypertensive therapy by adding a third antihypertensive drug to the therapy: CCB or a diuretic (thiazide / thiazide-like or loop). In case of resistant hypertension, it is necessary to consider the possibility of adding antagonists of mineralocorticoid receptors, other diuretics or alpha-blockers to the conducted AHT. Beta-blockers can be added at any stage of therapy if the patient has exertional angina, a history of myocardial infarction, atrial fibrillation, and chronic heart failure. The need to normalize blood pressure parameters by prescribing combined antihypertensive therapy in patients with diabetes and CKD is explained by a decrease in renal and cardiovascular risks, and, therefore, a decrease in the risk of mortality in this cohort of patients.

Modern approach to the treatment of arterial hypertension

2021 ◽  
pp. 28-34
Author(s):  
Dmitriy Sergeevich Kovalev
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Pathological Condition ◽  
Cardiovascular Complications ◽  
European Population ◽  
Modern Approach ◽  
Appropriate Treatment ◽  
Literary Sources ◽  
The Impact

Arterial hypertension (AH) refers to an increase in blood pressure above the level of 140/90 mm Hg; the risk of cardiovascular complications increases significantly with this pathological condition. Thus, arterial hypertension is an independent risk factor for the development of prediabetes / type 2 diabetes mellitus, heart failure, coronary heart disease, chronic kidney damage, and multifocal atherosclerosis. The frequency of arterial hypertension occurrence varies in different countries: in particular, it is from 23 to 36% for the European population, according to various literary sources. The main goal of treatment is to minimize the overall risk of developing cardiovascular complications. This involves the impact on all identified reversible risk factors, such as smoking and high cholesterol levels, and most importantly, appropriate treatment of concomitant diseases (diabetes mellitus, thyroid gland pathology, kidney disease, etc.), as well as the correction of high blood pressure.

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