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Diabetologia

, Volume 40, Issue 3, pp 302–306 | Cite as

Amiloride-sensitive Na+/H+ exchange in erythrocytes of patients with NIDDM: a prospective study

  • W. Koren
  • R. Koldanov
  • V. S. Pronin
  • I. Y. Postnov
  • E. Peleg
  • T. Rosenthal
  • M. Berezin
  • Y. V. Postnov

Summary

Intensive treatment of non-insulin-dependent diabetes mellitus (NIDDM) decreases the rate of microvascular complications, but is associated with increased incidence of cardiovascular morbidity. Enhanced permeability of plasma membranes for sodium (e. g. sodium-hydrogen exchange, NHE) may predict the subset of diabetic patients for whom intensive modalities of treatment are indicated despite their potential risk. However, the accuracy of NHE as a marker of microangiopathy has not been assessed. In this study NHE as initial velocity of amiloride-inhibited H+ efflux from erythrocytes (pH i 6.35–6.45) into an Na + -containing medium (pHo 7.95–8.05), was estimated during 8 years of follow-up in 138 non-microalbuminuric diabetic patients (74 women, 64 men, age 52 ± 4 years) treated with antihyperglycaemic drugs for 14 ± 2 years. Appearance of microalbuminuria, overt proteinuria, azotaemia and retinopathy was assessed annually. Enhanced erythrocyte NHE predicted diabetic nephropathy alone and in association with a family history of hypertension and/or nephropathy with a sensitivity of 86 and 93 %, respectively. No association was found between NHE and retinopathy in NIDDM. It is concluded that assessment of erythrocyte NHE can identify a subset of patients likely to develop renal damage, for whom an aggressive treatment approach might be considered. [Diabetologia (1997) 40: 302–306]

Keywords Na+/H+ exchange NIDDM diabetic nephropathy diabetic retinopathy erythrocytes. 

Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • W. Koren
    • 1
  • R. Koldanov
    • 1
  • V. S. Pronin
    • 2
  • I. Y. Postnov
    • 3
  • E. Peleg
    • 1
  • T. Rosenthal
    • 1
  • M. Berezin
    • 4
  • Y. V. Postnov
    • 3
  1. 1.Hypertension Unit, Chaim Sheba Medical Center, Tel Hashomer, IsraelIL
  2. 2.Institute of Endocrinology, Moscow, RussiaRU
  3. 3.Ministry of Health Central Research Laboratory, Moscow, RussiaRU
  4. 4.Endocrinology Institute, Chaim Sheba Medical Center, Tel Hashomer, IsraelIL

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