Skip Navigation

This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (25)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Rudberg, S.
Right arrow Articles by Osterby, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Rudberg, S.
Right arrow Articles by Osterby, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Nephrology Dialysis Transplantation, Vol 12, Issue 6 1149-1154, Copyright © 1997 by Oxford University Press

ORIGINAL ARTICLES

Decreasing glomerular filtration rate - an indicator of more advanced diabetic glomerulopathy in the early course of microalbuminuria in IDDM adolescents?

S Rudberg and R Osterby
Department of Woman and Child, Paediatric Unit, Karolinska Institute, Stockholm, Sweden; Electron Microscopy Laboratory, Institute of Experimental Clinical Research, Institute of Pathology, Arhus University, Arhus, Denmark; Corresponding author address: St Goran's Children's Hospital, S-112 81 Stockholm, Sweden

Background. Overt diabetic nephropathy is accompanied by a progressive decline in glomerular filtration rate (GFR). In this study we have investigated if a reduction of GFR already during the transition from normo- to microalbuminuria is associated with glomerular structural changes. Methods. Seventeen adolescents (11 girls/6 boys) with 10.5 (3.4) (mean, SD) years of IDDM were studied. GFR was previously measured in the normoalbuminuric stage 2-5 years prior to the renal biopsy, and measured again at the time for the biopsy, after in mean 1.8 years of microalbuminuria (15-200 &mgr;g/min). HbAlc and albumin excretion rate were measured 3 or 4 times yearly and blood pressure 1-4 times yearly between the GFR examinations. The associations between the yearly rate of fall in GFR and basement membrane (BM) thickness, mesangial and matrix volume fractions, matrix star volume, mean capillary diameter (CAPD), area of filtration surface (peripheral BM) per glomerulus, total capillary length per glomerulus, the ratio of peripheral BM to capillary surface, glomerular volume, and interstitial volume fraction were analysed. Results. BM thickness and matrix star volume were increased in patients with, as compared to those without, a decline in GFR⩾6 ml/min per year (P<0.005 respectively). Patients with previous glomerular hyperfiltration (⩾135 ml/min per 1.73 m2) showed the steepest decline in GFR; 11 ml/min per year versus -0.8 ml/min per year in previously normofiltering patients, P<0.001. The rate of fall in GFR was positively correlated to BM thickness (P<0.001), interstitial volume fraction (P=0.02) and CAPD (P=0.04), mean HbAlc (P=0.01), but not to the change in HbAlc between GFR examinations. Conclusion. A decreasing glomerular filtration rate in the early stage of microalbuminuria may be due to more advanced diabetic glomerulopathy than in IDDM patients with stable GFR. Keywords: basement membrane thickness; diabetic glomerulopathy; glomerular filtration rate; mesangial matrix; microalbuminuria; renal interstitium
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 CJASNHome page
E. T. Rosolowsky, L. H. Ficociello, N. J. Maselli, M. A. Niewczas, A. L. Binns, B. Roshan, J. H. Warram, and A. S. Krolewski
High-Normal Serum Uric Acid Is Associated with Impaired Glomerular Filtration Rate in Nonproteinuric Patients with Type 1 Diabetes
Clin. J. Am. Soc. Nephrol., May 1, 2008; 3(3): 706 - 713.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Soc. Nephrol.Home page
B. A. Perkins, L. H. Ficociello, B. E. Ostrander, K. H. Silva, J. Weinberg, J. H. Warram, and A. S. Krolewski
Microalbuminuria and the Risk for Early Progressive Renal Function Decline in Type 1 Diabetes
J. Am. Soc. Nephrol., April 1, 2007; 18(4): 1353 - 1361.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
S.-i. Araki, M. Haneda, T. Sugimoto, M. Isono, K. Isshiki, A. Kashiwagi, and D. Koya
Polymorphisms of the Protein Kinase C-{beta} Gene (PRKCB1) Accelerate Kidney Disease in Type 2 Diabetes Without Overt Proteinuria
Diabetes Care, April 1, 2006; 29(4): 864 - 868.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Soc. Nephrol.Home page
M. D. Breyer, E. Bottinger, F. C. Brosius III, T. M. Coffman, R. C. Harris, C. W. Heilig, K. Sharma, and for the AMDCC
Mouse Models of Diabetic Nephropathy
J. Am. Soc. Nephrol., January 1, 2005; 16(1): 27 - 45.
[Abstract] [Full Text] [PDF]

Home page
 DiabetesHome page
M. L. Caramori, P. Fioretto, and M. Mauer
Low Glomerular Filtration Rate in Normoalbuminuric Type 1 Diabetic Patients: An Indicator of More Advanced Glomerular Lesions
Diabetes, April 1, 2003; 52(4): 1036 - 1040.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
R. Osterby, H.-J. Bangstad, and S. Rudberg
Follow-up study of glomerular dimensions and cortical interstitium in microalbuminuric type 1 diabetic patients with or without antihypertensive treatment
Nephrol. Dial. Transplant., October 1, 2000; 15(10): 1609 - 1616.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.