Elevated Urinary Prostaglandin Excretion and the Effect of Indomethacin on Renal Function in Incipient Diabetic Nephropathy
Autor: | H. H. Parving, U. B. Olsen, Elisabeth R. Mathiesen, Eva Hommel |
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Rok vydání: | 1988 |
Předmět: |
Adult
medicine.medical_specialty Endocrinology Diabetes and Metabolism Urinary system Indomethacin Renal function Kidney Dinoprostone Nephropathy Excretion Endocrinology Diabetes mellitus Internal medicine Internal Medicine medicine Albuminuria Humans Diabetic Nephropathies business.industry Prostaglandins E Middle Aged medicine.disease Diabetes Mellitus Type 1 Prostaglandins Female Microalbuminuria medicine.symptom business Glomerular Filtration Rate Kidney disease |
Zdroj: | Diabetic Medicine. 5:145-149 |
ISSN: | 1464-5491 0742-3071 |
DOI: | 10.1111/j.1464-5491.1988.tb00961.x |
Popis: | We investigated whether the glomerular synthesis of prostaglandins modulates the glomerular filtration rate and urinary albumin excretion in incipient diabetic nephropathy (defined as urinary albumin excretion between 30 and 300 mg/24 h (microalbuminuria) in two out of three sterile ketone-free 24-h urine collections in patients having insulin-dependent diabetes mellitus (IDDM) without hypertension or other kidney disease). The urinary excretion of prostaglandin E2 was significantly elevated in 8 insulin-dependent diabetic patients with incipient nephropathy as compared with 9 normoalbuminuric IDDM patients and 11 healthy controls: 317 (182-1273); 95 (67-225); 132 (54-263) pg/min, respectively (2p less than 0.01). Glomerular filtration rate (single bolus 51Cr-EDTA technique) and albuminuria (radioimmunoassay) were measured twice within 2 weeks in 8 females having IDDM with incipient nephropathy. The study design was a randomized double-blind trial with the patients receiving either indomethacin (150 mg/day) or placebo for 3 days prior to the kidney function studies. Indomethacin treatment induced a significant reduction in urinary prostaglandin E2 excretion (73%) (2p less than 0.01), urinary albumin excretion rate diminished from 207 (63-253) to 87 (49-147) mg/24 h (2p less than 0.01), fractional clearance of albumin declined (70%) (2p less than 0.01). Glomerular filtration rate remained stable (108 (88-133) versus 110 (95-142) ml/min). Blood glucose and blood pressure were comparable during the placebo and indomethacin treatment (12.6 +/- 3 versus 13.4 +/- 5 mmol/l and 122/79 +/- 3/9 versus 122/82 +/- 4/10 mmHg, respectively). Our results suggest that enhanced glomerular synthesis of vasodilating prostaglandins may accelerate microalbuminuria in incipient diabetic nephropathy. |
Databáze: | OpenAIRE |
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