Natriuretic and vasoactive hormones and glomerular hyperfiltration in hyperglycaemic type 2 diabetic patients: effect of insulin treatment

Details

Serval ID
serval:BIB_2EC74198BFE6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Natriuretic and vasoactive hormones and glomerular hyperfiltration in hyperglycaemic type 2 diabetic patients: effect of insulin treatment
Journal
Nephron
Author(s)
Lalau  J. D., Westeel  P. F., Tenenbaum  F., Debussche  X., Nussberger  J., Tribout  B., Fardelonne  P., Favre  H., Fournier  A.
ISSN
0028-2766 (Print)
Publication state
Published
Issued date
1993
Volume
63
Number
3
Pages
296-302
Notes
Journal Article
Abstract
Evidence that an increase in plasma atrial natriuretic peptide (ANP) concentrations mediates, at least in part, glomerular hyperfiltration in diabetic rats prompted us to study the relationship between ANP and renal haemodynamics in hyperfiltering type 2 diabetic patients in association with other hormones implicated in the control of glomerular filtration rate (GFR) (catecholamines, vasopressin, renin) and in sodium tubular transport (aldosterone, ouabain-displacing factor, ODF). Since hyperglycaemia is also associated to hyperfiltration, diabetic patients who presented with secondary drug failure were studied both in hyperglycaemic and in normoglycaemic condition. For this purpose, 11 normotensive non-macroproteinuric hyperfiltering patients with type 2 diabetes were treated with an 8-day continuous insulin infusion (days 0-7). Dehydration was prevented or corrected and natriuresis was on day 0 above 100 mmol/day. The following parameters were determined on days 0 and 7: GFR and renal plasma flow (RPF) by 99mTc-DTPA and 131I-hippuran clearances; the extracellular volume, assimilated to the DTPA diffusion volume; urinary ODF by receptor-binding assay and urinary as well as plasma catecholamines by HPLC after extraction on alumin. Plasma ANP and antidiuretic hormone (ADH) were measured by radioimmunoassay after extraction on phenyl-silylsilica (ANP) and with ether (ADH). Unextracted plasma was used for radioimmunological measurement of plasma renin activity and aldosterone. When correcting hyperglycaemia to normoglycaemia GFR decreased from high to normal mean value (138 +/- 27 and 115 +/- 6 ml/min, p < 0.001), RPF followed the same trend, and the DTPA diffusion volume did not change.(ABSTRACT TRUNCATED AT 250 WORDS)
Keywords
Adult Aged Atrial Natriuretic Factor/*blood Diabetes Mellitus, Type 2/*blood/drug therapy/physiopathology Female Glomerular Filtration Rate Hormones/blood Humans Hyperglycemia/blood/drug therapy/physiopathology Insulin/therapeutic use Male Middle Aged Renal Circulation Vasopressins/blood
Pubmed
Web of science
Create date
05/03/2008 16:40
Last modification date
20/08/2019 13:13
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