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Glomerular hyperfiltration is associated with blood pressure abnormalities in normotensive normoalbuminuric IDDM patients.
Diabetes Care. 1997 Aug; 20(8):1329-33.DC

Abstract

OBJECTIVE

To analyze the blood pressure patterns in normoalbuminuric IDDM patients with glomerular hyperfiltration.

RESEARCH DESIGN AND METHODS

A controlled cross-sectional study of 38 normotensive normoalbuminuric (urinary albumin excretion rate < 20 micrograms/min) IDDM patients (18 hyperfiltering [glomerular filtration rate > 134 ml.min-1 1.73 m-2] and 20 normofiltering) and 20 normal individuals matched for age, sex, and BMI was performed. The 24-h ambulatory blood pressure was monitored using an auscultatory technique (Pressurometer IV, Del Mar Avionics), the glomerular filtration rate was measured by 51Cr-labeled EDTA method, extracellular volume by the distribution volume of 51Cr-labeled EDTA, and the 24-h urinary albumin excretion rate by radioimmunoassay.

RESULTS

Mean nocturnal diastolic blood pressure was higher in hyperfiltering IDDM patients (70.4 +/- mmHg), when compared with the control group (65.1 +/- 5.3 mmHg, P = 0.04). Diastolic blood pressure night:day ratio was higher in hyperfiltering IDDM patients (92.0 +/- 8.6%), when compared with normofiltering IDDM patients (85.9 +/- 4.8%) and control subjects (87.0 +/- 6.8%, P = 0.02). In IDDM patients, the glomerular filtration rate significantly correlated with the diastolic blood pressure night:day ratio (r = 0.5, P = 0.002), extracellular volume (r = 0.04, P = 0.002), and HbA1 (r = 0.3, P = 0.03). In stepwise multiple regression analysis, factors associated with glomerular filtration rate were diastolic blood pressure night:day ratio, extracellular volume, and HbA1 (adjusted r2 = 0.27, P = 0.003).

CONCLUSIONS

Glomerular hyperfiltration is associated with higher nocturnal diastolic blood pressure and with a blunted nocturnal decrease in diastolic blood pressure levels in normotensive and normoalbuminuric IDDM patients.

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Authors+Show Affiliations

Pecis M
Endocrine Unit, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Azevedo MJ
No affiliation info available
Gross JL
No affiliation info available

MeSH

AdolescentAdultAlbuminuriaBlood PressureBlood Pressure Monitoring, AmbulatoryCross-Sectional StudiesDiabetes Mellitus, Type 1FemaleGlomerular Filtration RateGlycated Hemoglobin AHumansMaleMiddle AgedRegression AnalysisRetrospective Studies

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9250464

Citation

Pecis, M, et al. "Glomerular Hyperfiltration Is Associated With Blood Pressure Abnormalities in Normotensive Normoalbuminuric IDDM Patients." Diabetes Care, vol. 20, no. 8, 1997, pp. 1329-33.
Pecis M, Azevedo MJ, Gross JL. Glomerular hyperfiltration is associated with blood pressure abnormalities in normotensive normoalbuminuric IDDM patients. Diabetes Care. 1997;20(8):1329-33.
Pecis, M., Azevedo, M. J., & Gross, J. L. (1997). Glomerular hyperfiltration is associated with blood pressure abnormalities in normotensive normoalbuminuric IDDM patients. Diabetes Care, 20(8), 1329-33.
Pecis M, Azevedo MJ, Gross JL. Glomerular Hyperfiltration Is Associated With Blood Pressure Abnormalities in Normotensive Normoalbuminuric IDDM Patients. Diabetes Care. 1997;20(8):1329-33. PubMed PMID: 9250464.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glomerular hyperfiltration is associated with blood pressure abnormalities in normotensive normoalbuminuric IDDM patients. AU - Pecis,M, AU - Azevedo,M J, AU - Gross,J L, PY - 1997/8/1/pubmed PY - 1997/8/1/medline PY - 1997/8/1/entrez SP - 1329 EP - 33 JF - Diabetes care JO - Diabetes Care VL - 20 IS - 8 N2 - OBJECTIVE: To analyze the blood pressure patterns in normoalbuminuric IDDM patients with glomerular hyperfiltration. RESEARCH DESIGN AND METHODS: A controlled cross-sectional study of 38 normotensive normoalbuminuric (urinary albumin excretion rate < 20 micrograms/min) IDDM patients (18 hyperfiltering [glomerular filtration rate > 134 ml.min-1 1.73 m-2] and 20 normofiltering) and 20 normal individuals matched for age, sex, and BMI was performed. The 24-h ambulatory blood pressure was monitored using an auscultatory technique (Pressurometer IV, Del Mar Avionics), the glomerular filtration rate was measured by 51Cr-labeled EDTA method, extracellular volume by the distribution volume of 51Cr-labeled EDTA, and the 24-h urinary albumin excretion rate by radioimmunoassay. RESULTS: Mean nocturnal diastolic blood pressure was higher in hyperfiltering IDDM patients (70.4 +/- mmHg), when compared with the control group (65.1 +/- 5.3 mmHg, P = 0.04). Diastolic blood pressure night:day ratio was higher in hyperfiltering IDDM patients (92.0 +/- 8.6%), when compared with normofiltering IDDM patients (85.9 +/- 4.8%) and control subjects (87.0 +/- 6.8%, P = 0.02). In IDDM patients, the glomerular filtration rate significantly correlated with the diastolic blood pressure night:day ratio (r = 0.5, P = 0.002), extracellular volume (r = 0.04, P = 0.002), and HbA1 (r = 0.3, P = 0.03). In stepwise multiple regression analysis, factors associated with glomerular filtration rate were diastolic blood pressure night:day ratio, extracellular volume, and HbA1 (adjusted r2 = 0.27, P = 0.003). CONCLUSIONS: Glomerular hyperfiltration is associated with higher nocturnal diastolic blood pressure and with a blunted nocturnal decrease in diastolic blood pressure levels in normotensive and normoalbuminuric IDDM patients. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/9250464/Glomerular_hyperfiltration_is_associated_with_blood_pressure_abnormalities_in_normotensive_normoalbuminuric_IDDM_patients_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=9250464.ui DB - PRIME DP - Unbound Medicine ER -