Summary
Renal clearance of dextran of two ranges of molecular size and glomerular filtration rate (GFR,51Cr-EDTA) were measured in seven short-term insulin-dependent diabetics (mean age 25 years). Measurements were carried out in the same patient during good and poor metabolic regulation (plasma glucose, mean±SEM, 6.5±0.9 and 14.8±1.5 ] mmol/l, respectively). GFR was elevated in all patients during poor metabolic regulation (119±6 ml/min/1.73 m2, versus 99±2 ml/min/1.73 m2 during good control, p<0.01). The average renal clearance of dextran with molecular weights ranging from 25,000 to 35,000 and 35,000 to 45,000 increased during poor metabolic regulation from 14.8±0.8 to 19.8±1.8 ml/min/1.73 m2, and 5.2±0.3 to 6.8±0.6 ml/min/1.73 m2, respectively (p< 0.05). The elevated GFR and renal dextran clearance found during poor metabolic regulation were normalized within one to three weeks of effective insulin treatment. This rapid reversibility can hardly be explained by the previously demonstrated enlargement in glomerular size and filtration surface area, since these alterations remain unchanged after more than one month of insulin treatment. The metabolic regulation did not influence the size-selective properties of the glomerular wall. Therefore, we suggest that the dominating mechanism involved in the GFR and renal dextran clearance alterations is functional, viz. increased filtration pressure.
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Artursson, G., Granath, K.: Dextrans as test molecules in studies of the functional ultrastructure of biological membranes. Clin. Chim. Acta37, 309–322 (1972)
Brenner, B.M., Hostetter, T.H., Humes, H.D.: Molecular basis of proteinuria of glomerular origin. N. Engl. J. Med.298, 828–833 (1978)
Brenner, B.M., Humes, H.D.: Mechanics of glomerular Ultrafiltration. N. Engl. J. Med.297, 148–154 (1977)
Brøchnermortensen, J., Giese, J., Rossing, N.: Renal inulin clearance versus total plasma clearance of51Cr-EDTA. Scand. J. Clin. Lab. Invest.23, 301–305 (1969)
Brøchner-Mortensen, J.: Glomerular filtration rate and extracellular fluid volumes during normoglycemia and moderate hyperglycemia in diabetics. Scand. J. Clin. Lab. Invest.32, 311–316 (1973)
Burt, J.R.: Automated analyses of sugar phosphates. Anal. Biochem.9, 293–302 (1964)
Ditzel, J., Junker, K.: Abnormal glomerular filtration rate, renal plasma flow, and renal protein excretion in recent and short-term diabetics. Br. Med. J.1972 II, 13–19
Hanssen, K.F.: Radioimmunoassay for growth hormone in human plasma. Acta Endocrinol. (Kbh.)71, 649–664 (1972)
Hanssen, K.F.: Urinary growth hormone. Oslo: Universitetsforlagets Tryknings Sentral 1975
Hostetter, T.H., Fray, J.L., Brenner, B.M.: Glomerular dynamics in rats with diabetes mellitus. Kidney Int.14, 725 (1978)
Kroustrup, J.P., Gundersen, H.J.G., Østerby, R.: Glomerular size and structure in diabetes mellitus. III. Early enlargement of the capillary surface. Diabetologia13, 207–210 (1977)
Laurell, C.-B.: Quantitative estimation of proteins by electrophoresis in agarose gel containing antibodies. Anal. Biochem.15, 45–52 (1966)
Mogensen, C.E.: The glomerular permeability determined by dextran clearance using sephadex gel filtration. Scand. J. Clin. Lab. Invest.21, 77–82 (1968)
Mogensen, C.E.: Kidney function and glomerular permeability to macromolecules in early juvenile diabetes. Scand. J. Clin. Lab. Invest.28, 79–90 (1971)
Mogensen, C.E.: Kidney function and glomerular permeability to macromolecules in juvenile diabetes. Dan. Med. Bull.19, [Suppl. 3], 1–40 (1972)
Mogensen, C.E.: Renal function changes in diabetes. Diabetes25 [Suppl. 2], 872–879 (1976)
Parving, H.-H., Noer, I., Deckert, T., Evrin, P.-E., Nielsen, S.L., Lyngsøe, J., Mogensen, C.E., Rørth, M., Svendsen, P. Aa., Trap-Jensen, J., Lassen, N.A.: The effect of metabolic regulation on microvascular permeability to small and large molecules in short-term juvenile diabetics. Diabetologia12, 161–166 (1976)
Venkatachalam, M.A., Rennke, H.G.: The structural and molecular basis of glomerular filtration. Circ. Res.43, 337–347 (1978)
Wallenius, G.: Renal clearance of dextran as a measure of glomerular permeability. Uppsala: Almquist & Wiksells Boktryckeri 1954
Østerby, R., Gundersen, H.J.G.: Glomerular size and structure in diabetes mellitus. I. Early abnormalities. Diabetologia11, 225–229 (1975)
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Parving, H.H., Rutili, F., Granath, K. et al. Effect of metabolic regulation on renal leakiness to Dextran molecules in short-term insulin-dependent diabetics. Diabetologia 17, 157–160 (1979). https://doi.org/10.1007/BF01219742
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DOI: https://doi.org/10.1007/BF01219742