RENAL-FUNCTION CHANGES IN HYPERTENSIVE PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

Citation
F. Rius et al., RENAL-FUNCTION CHANGES IN HYPERTENSIVE PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS, Kidney international, 1996, pp. 88-90
Citations number
11
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology
Journal title
ISSN journal
0085-2538
Year of publication
1996
Supplement
55
Pages
88 - 90
Database
ISI
SICI code
0085-2538(1996):<88:RCIHPW>2.0.ZU;2-5
Abstract
A group of 146 patients with non-insulin-dependent diabetes mellitus ( NIDDM) was studied. They were divided into two groups of 73 age and se x matched patients, according to the presence or absence of hypertensi on. We recorded the presence of macrovascular and microvascular compli cations of NIDDM, family history, body mass index (BMI), glycemic cont rol and lipidic profile. Renal parameters included plasma creatinine, urinary albumin excretion rate (UAER), glomerular filtration rate (GFR ), effective renal plasma how (ERPF) and filtration fraction. Hyperten sive patients had a higher BMI (30 +/- 4.8 kg/m(2) vs. 27.6 +/- 4.4 kg /m(2), P < 0.005), total cholesterol (6.34 +/- 1.47 mmol/l vs. 5.72 +/ - 1.14 mmol/liter, P < 0.01), creatinine (91.1 +/- 25.6 mu mol/liter v s. 81.3 +/- 20.3 mu mol/liter, P < 0.05) and UAER [63.7 (range 1 to 51 60) mg/24 hr vs. 27.3 (3 to 5500) mg/24 hr, P < 0.001]. GFR was lower in the group with hypertension (113 +/- 35 ml . min(-1). 1.73 m(-2) vs . 127 +/- 29 ml . min(-1). 1.73 m(-2), P < 0.05), but there were no di fferences in ERPF. The difference in GFR was only apparent in patients without established diabetic nephropathy. Hypertensive patients had h igher frequency of ischemic heart disease (18% vs. 6%, P < 0.05) and d iabetic nephropathy (62% vs. 38%, P < 0.005). We conclude hypertensive NIDDM patients, when compared with normotensive NIDDM patients, are m ore obese, hypercholesterolemic and have a higher frequency of ischemi c heart disease and diabetic nephropathy. Hypertensive NIDDM patients have a worse renal function than normotensives before clinical protein uria appears. The deterioration of GFR in hypertensive NIDDM patients possibly has an important influence on the progression of diabetic nep hropathy.