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Kidney function and glomerulopathy over 8 years in young patients with Type I (insulin-dependent) diabetes mellitus and microalbuminuria.
Diabetologia 2002; 45(2):253-61D

Abstract

AIMS/HYPOTHESIS

We aimed to investigate prospectively the interrelation between kidney function and glomerular morphological changes over 8 years in young patients with Type I (insulin-dependent) diabetes mellitus and microalbuminuria.

METHODS

Kidney biopsies were taken at baseline and after 8 years in 18 subjects who were 20 years of age (19-29 mean and range), had duration of diabetes for 11 years (7-18), and who had an albumin excretion rate of 45 microg/min (15-194). The glomerular ultrastructural parameters were analysed using stereological methods.

RESULTS

At the end of the study three patients had an increased albumin excretion rate of more than 25 % a year, two of whom developed overt nephropathy. Glomerular filtration rate declined 2.3 ml/min x 1.73 m(-2) x yr(-1). Glomerular volume, volume fractions of matrix and mesangium, and basement membrane thickness showed an increase over the 8 years. Multiple regression analysis showed that mean 8-years HbA(1 c), matrix volume fraction(baseline) and basement membrane thickness BMT(baseline) accounted for 70 % of the variation in AER at the end of the study. Mesangial volume fraction(baseline,) glomerular filtration fraction(baseline,) and mean 8-year HbA(1 c) accounted for 73 % of the change in glomerular filtration rate from baseline. Smoking was strongly associated with the glomerular filtration rate at baseline (r = 0.65). When glomerular filtration rate(baseline) was omitted from the equation, smoking was the only significant parameter linked to the change in glomerular filtration rate from the baseline.

CONCLUSION/INTERPRETATION

In patients who had diabetes for 20 years, long-term hyperglycaemia and glomerulopathy found 8 years prior to the study, and possibly smoking, affected renal function (i. e. albumin excretion rate and glomerular filtration rate).

Authors+Show Affiliations

Department of Paediatrics, Ullevål University Hospital, Oslo, Norway. h.j.bangstad@ioks.uio.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11935157

Citation

Bangstad, H-J, et al. "Kidney Function and Glomerulopathy Over 8 Years in Young Patients With Type I (insulin-dependent) Diabetes Mellitus and Microalbuminuria." Diabetologia, vol. 45, no. 2, 2002, pp. 253-61.
Bangstad HJ, Østerby R, Rudberg S, et al. Kidney function and glomerulopathy over 8 years in young patients with Type I (insulin-dependent) diabetes mellitus and microalbuminuria. Diabetologia. 2002;45(2):253-61.
Bangstad, H. J., Østerby, R., Rudberg, S., Hartmann, A., Brabrand, K., & Hanssen, K. F. (2002). Kidney function and glomerulopathy over 8 years in young patients with Type I (insulin-dependent) diabetes mellitus and microalbuminuria. Diabetologia, 45(2), pp. 253-61.
Bangstad HJ, et al. Kidney Function and Glomerulopathy Over 8 Years in Young Patients With Type I (insulin-dependent) Diabetes Mellitus and Microalbuminuria. Diabetologia. 2002;45(2):253-61. PubMed PMID: 11935157.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kidney function and glomerulopathy over 8 years in young patients with Type I (insulin-dependent) diabetes mellitus and microalbuminuria. AU - Bangstad,H-J, AU - Østerby,R, AU - Rudberg,S, AU - Hartmann,A, AU - Brabrand,K, AU - Hanssen,K F, PY - 2002/4/6/pubmed PY - 2002/8/1/medline PY - 2002/4/6/entrez SP - 253 EP - 61 JF - Diabetologia JO - Diabetologia VL - 45 IS - 2 N2 - AIMS/HYPOTHESIS: We aimed to investigate prospectively the interrelation between kidney function and glomerular morphological changes over 8 years in young patients with Type I (insulin-dependent) diabetes mellitus and microalbuminuria. METHODS: Kidney biopsies were taken at baseline and after 8 years in 18 subjects who were 20 years of age (19-29 mean and range), had duration of diabetes for 11 years (7-18), and who had an albumin excretion rate of 45 microg/min (15-194). The glomerular ultrastructural parameters were analysed using stereological methods. RESULTS: At the end of the study three patients had an increased albumin excretion rate of more than 25 % a year, two of whom developed overt nephropathy. Glomerular filtration rate declined 2.3 ml/min x 1.73 m(-2) x yr(-1). Glomerular volume, volume fractions of matrix and mesangium, and basement membrane thickness showed an increase over the 8 years. Multiple regression analysis showed that mean 8-years HbA(1 c), matrix volume fraction(baseline) and basement membrane thickness BMT(baseline) accounted for 70 % of the variation in AER at the end of the study. Mesangial volume fraction(baseline,) glomerular filtration fraction(baseline,) and mean 8-year HbA(1 c) accounted for 73 % of the change in glomerular filtration rate from baseline. Smoking was strongly associated with the glomerular filtration rate at baseline (r = 0.65). When glomerular filtration rate(baseline) was omitted from the equation, smoking was the only significant parameter linked to the change in glomerular filtration rate from the baseline. CONCLUSION/INTERPRETATION: In patients who had diabetes for 20 years, long-term hyperglycaemia and glomerulopathy found 8 years prior to the study, and possibly smoking, affected renal function (i. e. albumin excretion rate and glomerular filtration rate). SN - 0012-186X UR - https://www.unboundmedicine.com/medline/citation/11935157/Kidney_function_and_glomerulopathy_over_8_years_in_young_patients_with_Type_I__insulin_dependent__diabetes_mellitus_and_microalbuminuria_ L2 - https://dx.doi.org/10.1007/s00125-001-0744-y DB - PRIME DP - Unbound Medicine ER -