Diabetic Nephropathy: New Pathogenetic Aspects

  • August Heidland
  • Markus Teschner
  • Roland Schaefer
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 252)

Abstract

200 years ago the well-known Italian physician Domenico Cotugno was the first to describe the appearance of protein in the urine of diabetics. He noted that urine of many diabetics coagulates when exposed to heat (1,2). In the past several years a better understanding of the mechanisms and consequences of proteinuria has been developed.

Keywords

Neuropathy Macromolecule Indomethacin Hyperglycemia Glucagon 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literature

  1. 1.
    D. Contunnii, “De ischiade nervosa conmentarius”, Napoli (1764)Google Scholar
  2. 2.
    C. Haslacher and E. Ritz, Effect of control of diabetes mellitus on progression of renal failure, Kidney Int., 22: 853 (1987)Google Scholar
  3. 3.
    C.E. Mogensen, C.K. Christensen and E. Vittinghas, The stages in diabetic renal disease with emphasis on the stage of incipient nephropathy, Diabetologia 32: 64 (1983)Google Scholar
  4. 4.
    T. Deckert, J.E. Poulsen and M. Larsen, Prognosis of diabetes with diabetes onset before the age of thirty-one. Survival, causes of death, and complications. Dia- betologia 14: 363 (1978)CrossRefGoogle Scholar
  5. 5.
    T. Deckert, J.E. Poulsen and M. Larsen, Prognosis of diabetes with diabetes onset before the age of thirty-one. Factors influencing the prognosis, Diabetologia 14: 371 (1978)PubMedCrossRefGoogle Scholar
  6. 6.
    A.S. Krolewski, J.H. Warram, A.R. Christlieb, E.J. Busieck and C.R. Kahn, The changing natural history of nephropathy in type I diabetes. Am. J. Med. 78 (S): 785 (1985)PubMedCrossRefGoogle Scholar
  7. 7.
    C.E. Mogensen, High blood pressure as a factor in the progression of diabetic nephropathy. Acta Med. Scand. (Suppl.), 602: 29 (1976)Google Scholar
  8. 8.
    S.M. Mauer, W.M. Steffes, S. Azar, S.K. Sandberg and D.M. Brown, The effects of Goldblatt hypertension on development of the glomerular lesions of diabetes mellitus in the rat, Diabetes 27: 738 (1978)PubMedCrossRefGoogle Scholar
  9. 9.
    A.M. Cohen and E. Rosenmann, Role of genetics, hypertension (Goldblatt Kidney) and carbohydrate metabolism disturbance on the development of diabetic nephropathy, Diab. Nephr., 4: 66 (1985)Google Scholar
  10. 10.
    C.H. Haslacher, W. Stech, P. Wahl and E. Ritz, Blood pressure and metabolic control as risk factors for nephropathy in type 1 diabetes, Diabetologia, 28: 6 (1985)CrossRefGoogle Scholar
  11. 11.
    C.E. Mogensen, Early glomerular hyperfTitration in insulin-dependent diabetics and late nephropathy. Scand. J. Clin. Lab. Invest, 46: 201 (1986)PubMedCrossRefGoogle Scholar
  12. 12.
    A. Kofoed-Enevoldsen, K. Borch-Johnsen, S. Kreiner, J. Nerup and T. Deckert, Declining incidence of persistent proteinuria in type I (insulin-dependent) diabetes. Diabetes, 36 (2): 205 (1987)PubMedCrossRefGoogle Scholar
  13. 13.
    J.S. Christiansen, Cigarette smoking and prevalence of microangiopathy in juvenile onset insulin-dependent diabetes mellitus. Diabetes Care 1: 146 (1978)PubMedCrossRefGoogle Scholar
  14. 14.
    I. Mühlhauser, P. Sawicki and M. Berger, Cigarette smoking as a risk factor for macroproteinuria and proliferative retinopathy in type 1 (insulin-dependent) diabetes. DiabetoloRia, 29: 500 (1986)CrossRefGoogle Scholar
  15. 15.
    A.S.D. Krolewski, M.D. Canessa, J.H. Warram, L.M.B. Laffel, R.A. Christlieb, W. Knowler, L. Rand, Predisposition to hypertension and susceptibility to renal disease in insulin-dependent diabetes mellitus, N. Engl. J. Med., 318: 140 (1988)PubMedCrossRefGoogle Scholar
  16. 16.
    H.H. Parving, B. Oxenboll, P.A. Svendsen and A.R. Andersen, Early detection of patients at risk developing diabetic nephropathy. Acta Endocr., 100: 500 (1982)Google Scholar
  17. 17.
    G.C. Viberti, R.D. Hill, R.J. Jarrett, A. Argyropoulos, U. Mahmud and H. Keen, Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet, 1: 1430 (1982)PubMedCrossRefGoogle Scholar
  18. 18.
    C.E. Mogensen and C.K. Christensen, Predicting diabetic nephropathy in insulin-dependent patients, N. Engl. J. Med.. 311: 89 (1984)PubMedCrossRefGoogle Scholar
  19. 19.
    C.E. Mogensen, A. Chachati, C.K. Christensen, C.F. Close, T. Deckert, E. Hommel, J. Kastrup, P. Lefebvre, E.R. Mathiesen, B. Feldt-Rasmussen, A. Schmitz and G.C. Viberti, Microalbuminuria. An early marker of renal involvement in diabetes. Uremia Investigation, 9: 85 (1985)PubMedGoogle Scholar
  20. 20.
    S. Aziz, A.H. Cohen, R.L. Winer, F. Llach and S.G. Massry, Diabetes mellitus with immune complex glomerulonephritis, Nephron, 23: 32 (1979)PubMedCrossRefGoogle Scholar
  21. 21.
    J. Olivero and W.N. Suki, Acute glomerulonephritis complicating diabetic nephropathy. Archs. Intern. Med., 137: 732 (1977)CrossRefGoogle Scholar
  22. 22.
    T. Cavallo, J. Pinto and S. Rajaramon, Immune complex disease complicating diabetic glomerulosclerosis. Am. J. Nephrol., 4: 347 (1984)PubMedCrossRefGoogle Scholar
  23. 23.
    B. Feldt-Rasmussen, Increased transcapillary escape rate of albumin in insulin-dependent diabetic patients with microalbuminuria, Diabetologia, 29: 282 (1986)PubMedCrossRefGoogle Scholar
  24. 24.
    L. Bent-Hansen, B. Feldt-Rasmussen, A. Kverneland and T. Deckert, Transcapillary escape rate and relative metabolic clearance of glycated and non-glycated albumin in type 1 (insulin-dependent) diabetes mellitus, Diabetologia, 30: 2 (1987)PubMedCrossRefGoogle Scholar
  25. 25.
    M. Wiseman, G. Viberti, D. Mackintosh, R.J. Jarrett and H. Keen, Glycemia, arterial pressure and microalbuminuria in type 1 (insulin-dependent) diabetes mellitus, Diabetologia, 26: 401 (1984)PubMedCrossRefGoogle Scholar
  26. 26.
    H.H. Parving, E. Hoimnel, E. Mathiesen, P. Skott, B. Edsberg, M. Bahnsen, M. Lauritzen and P. Hougaard, Prevalence of microalbuminuria, arterial hypertension, retinopathy and neuropathy in patients with insulin-dependent diabetes, Br. Med. J., 296: 156 (1988)CrossRefGoogle Scholar
  27. 27.
    M.P. Cohen and C. Vogt, Evidence for enhanced basement membrane synthesis and lysine hydroxylation in renal glomerulus in experimental diabetes, Biochem. Biophys. Res. Commun., 49: 1542 (1972)PubMedCrossRefGoogle Scholar
  28. 28.
    M.E. Grant, R. Harwood and I.F. Williams, Increased synthesis of glomerular basement membrane collagen in streptozotocin diabetes, J. Physiol. (London), 257: 56P (1976)Google Scholar
  29. 29.
    M.P. Cohen and A. Khalifa, Effect of diabetes and insulin on rat glomerular protocollagen hydroxylase activities, Biochem. Biophys. Acta, 496: 88 (1977)CrossRefGoogle Scholar
  30. 30.
    M.P. Cohen, Glomerular basement membrane synthesis in diabetes. In: Kefalides, N.A. (ed.) Biology and Chemistry of Basement Membranes. Academic Press, New York, San Francisco, London, 523 (1978)Google Scholar
  31. 31.
    W. Romen and R. Morath, Diffuse glomerulosclerosis – a dysfunction of the mesangium? Virchows Arch. (Cell Pathol.), 31: 205 (1979)CrossRefGoogle Scholar
  32. 32.
    W. Romen, Zur Morphologie und Pathogenese der diabetischen Glomerulosklerose. Klin. Wochenschr., 58: 1013 (1980)PubMedCrossRefGoogle Scholar
  33. 33.
    W. Romen and A. Takahashi, Autoradiographic studies of the proliferation of glomerular and tubular cells of the rat kidney in early diabetes, Virchows. Arch. (Cell Pathol.), 40: 339 (1982)CrossRefGoogle Scholar
  34. 34.
    D.H. Rohrbach, C.W. Wagner, V.L. Star, G.R. Martin, K.S. Brown and I.W. Yoon, Reduced synthesis of basement membrane heparan sulfate proteoglycan in streptozotocin-induced diabetic mice, J. Biolog. Chem., 258: 11672 (1983)Google Scholar
  35. 35.
    T. Deckert, B. Feldt-Rasmussen, R. Djurup and M. Deckert, Glomerular size and charge selectivity in insulin-dependent diabetes mellitus. Kidney Int., 33: 100 (1988)PubMedCrossRefGoogle Scholar
  36. 36.
    T.H. Hostetter, H.G. Rennke and B.M. Brenner, The case for intrarenal hypertension in the initiation and progression of diabetic and other glomerulopathies. Am. J. Med., 72: 375 (1982)PubMedCrossRefGoogle Scholar
  37. 37.
    T.H. Hostetter, Diabetic nephropathy, N. Engl. J. Med., 312: 642 (1985)Google Scholar
  38. 38.
    R. Zatz, T.W. Meyer, H.G. Rennke and B.M. Brenner, Predominance of hemodynamic rather than metabolic factors in the pathogenesis of diabetic glomerulopathy, Proc. Natl. Acad. Sci., 82: 5963 (1985)PubMedCrossRefGoogle Scholar
  39. 39.
    C.E. Mogensen, Glomerular filtration rate and renal plasma flow in short-term and long-term juvenile diabetes mellitus, Scand. J. Clin. Lab. Invest., 28: 91 (1971)PubMedCrossRefGoogle Scholar
  40. 40.
    C.E. Mogensen and M.J.F. Andersen, Increased kidney size and glomerular filtration rate in early juvenile diabetes, Diabetes, 22: 706 (1973)PubMedGoogle Scholar
  41. 41.
    J.S. Christiansen, M. Frandsen and H.H. Parving, Effect of intravenous glucose infusion on renal function in normal and in insulin-dependent diabetics. Diabetologia 21: 368 (1981)PubMedCrossRefGoogle Scholar
  42. 42.
    M.J. Wiseman, R. Mangili, M. Alberetto, H. Keen and G. Viberti, Glomerular response mechanisms to glycemic changes in insulin-dependent diabetics. Kidney Int., 31: 1012 (1987)PubMedCrossRefGoogle Scholar
  43. 43.
    R.C. Blantz, O.W. Peterson, L. Gushwa, B.J. Tucker, Effect of modest hyperglycemia on tubuloglomerular feedback activity. Kidney Int., 22: 206 (1982)Google Scholar
  44. 44.
    C. Kinddermans, K. Laborde, B. Thiriet, L. Marchal, C. Sachs and M. Dechaux, Atrial natriuretic peptide (ANF) in type 1 diabetes: relationship with glomerular filtration rate, extracellular fluid volume and plasma renin activity. Kidney Int., 33: 270 A (1983)Google Scholar
  45. 45.
    S.L. Jones, N. Perico, A. Benigni, G. Remuzzi, G.C. Viberti, Glomerular filtration rate, extracellular fluid volume and atrial natriuretic factor in insulin dependent diabetes. Kidney Int., 33: 268 A (1988)Google Scholar
  46. 46.
    G.M. Bell, R.K. Bernstein, S.A. Atlas, G.D. James, M.S. Pecker, J.E. Sealey and J.H. Laragh, Increased plasma atrial natriuretic factor in early controlled diabetes mellitus, Kidney Int., 33: 254 A (1988)Google Scholar
  47. 47.
    F.V. Ortola, B.J. Ballermann, S. Anderson and B.M. Brenner, A role for atrial natriuretic peptide in mediating glomerular hyperfiltration in diabetic rats. 10th Int. Cong. of Nephrology, London, 205 (1987)Google Scholar
  48. 48.
    S.A. Goldfarb, D.A. Simmons, and E. Kern, Amelioration of glomerular hyperfiltration in acute experimental diabetes by dietary myo-inositol and by an aldose reductase inhibitor, Clin. Res., 34: 725 A (1986)Google Scholar
  49. 49.
    R. Trevisan, R. Nosadini, P. Fioretto, A. Avogaro, E. Duner, E. Jori, A. Valerio, A. Doria and G. Crepaldi, Ketone bodies increase glomerular filtration rate in normal man and in patients with type 1 (insulin-depen- dent) diabetes mellitus. Diabetologia, 30: 214 (1987)PubMedCrossRefGoogle Scholar
  50. 50.
    M. Schambelan, S. Blake, J. Sraer, M. Bens, M.P. Nivez and F. Wahbe, Increased prostaglandin production by glomeruli isolated from rats with streptozotocin-in- duced diabetes mellitus, J. Clin. Invest., 75: 404 (1985)PubMedCrossRefGoogle Scholar
  51. 51.
    J.S. Christiansen, B. Feldt-Rasmussen and H.-H. Parving, Short-term inhibition of prostaglandin synthesis has no effect on the elevated glomerular filtration rate of early insulin-dependent diabetes, Diabet. Med., 2: 17 (1985)PubMedCrossRefGoogle Scholar
  52. 52.
    E. Hommel, E. Mathiesen, S. Arnold-Larsen, B. Edsberg, U. B. Olsen and H.-H. Parving, Effects of indomethacin on kidney function in type 1 (insulin-dependent) diabetic patients with nephropathy, DiabetoloRia, 30: 78 (1987)Google Scholar
  53. 53.
    M.J. Wiseman, G.C. Viberti, S. Redmond and H. Keen, The glomerular hyperfiltration of diabetes is not associated with elevated plasma levels of glucagon and growth hormone, Diabetologia, 28: 718 (1985)PubMedGoogle Scholar
  54. 54.
    N. Bank, R. Klose, H.S. Aynedjian, D. Nguyen and L.B. Sablay, Evidence against increased glomerular pressure indicating diabetic nephropathy, Kidney Int., 31: 898 (1987)PubMedCrossRefGoogle Scholar
  55. 55.
    M.P. Cohen, Diabetes and Protein Glycosylation. Measurement and Biologic Relevance. Springer-Verlag, New York- Berlin-Heidelberg-Tokyo, 1 - 142 (1986)CrossRefGoogle Scholar
  56. 56.
    J. Ditzel, Changes in red cell oxygen release capacity in diabetes mellitus. Fed. Proc., 38: 2484 (1977)Google Scholar
  57. 57.
    S.K. Williams and N.J. Solenski, Enhanced vesicular ingestion of non-enzymatically glucosylated proteins by capillary endothelium, Microvasc. Res., 28: 311 (1984)PubMedCrossRefGoogle Scholar
  58. 58.
    M.A. Cohenford, J.C. Urbanowski, D.C. Shepard, et al., Nonenzymatic glycosylation of human IgG: In vitro preparation, Immunol. Commun., 12: 189 (1983)PubMedGoogle Scholar
  59. 59.
    J.L. Witztum, E.M. Mahoney, M.J. Branks, et al., Nonenzymatic glucosylation of low-density lipoproteins alters its biologic activity. Diabetes, 31: 283 (1982)PubMedCrossRefGoogle Scholar
  60. 60.
    H.J. Kim and I.V. Kurup, Decreased catabolism of glycosylated low density lipoprotein in diabetic rats. Diabetes, 26: 218 (1984)Google Scholar
  61. 61.
    M. Brownlee, H. Vlassara and A. Cerami, Nonenzymatic glycosylation reduces the susceptibility of fibrin to degradation by plasmin. Diabetes, 32: 680 (1983)PubMedCrossRefGoogle Scholar
  62. 62.
    R.N. Banerjee, A.L. Sahni and V. Kumar: Antithrombin 3 deficiency in maturity onset diabetes mellitus and atherosclerosis, Thromb. Diath. Haemorrh., 31: 339 (1974)PubMedGoogle Scholar
  63. 63.
    M.P. Cohen, E. Urdanivia, M. Surma and V.Y. Wu, Nonenzymatic glycosylation of basement membrane. In vitro studies. Diabetes, 30, 367 (1981)PubMedCrossRefGoogle Scholar
  64. 64.
    M. Bronlee, H. Vlassara and A. Cerami, Nonenzymatic glycosylation and the pathogenesis of diabetic complications, Ann. Int. Med., 101: 527 (1984)Google Scholar
  65. 65.
    C.N. Cordes, J.M. Braughles and P.A. Culp, Quantitative histochemistry of the sorbitol pathway in glomeruli and small arteries of the human diabetic kidney, Folia Histochem. Cytochem., 17: 137 (1979)Google Scholar
  66. 66.
    M.P. Cohen, A. Sasmahapatra and E. Shapiro, Reduced glomerular sodium potassium adenosine triphosphatase activity in acute streptozotocin diabetes. Diabetes, 34: 1071 (1985)PubMedCrossRefGoogle Scholar
  67. 67.
    A. Beyer-Mears, L. Ku. and M.P. Cohen, Glomerular polyolaccumulation in diabetes and its prevention by oral sorbinil. Diabetes, 33: 604 (1984)PubMedCrossRefGoogle Scholar
  68. 68.
    A. Beyer-Mears, E. Varagiannis and E. Cruz, Effect of sorbinil on reversal of proteinuria. Diabetes, 35 (Suppl, 1): l0lA (1985)Google Scholar
  69. 69.
    E.N. Wardle, Mesangial cell dysfunction detected by accumulation of aggregated protein in rats with streptozotocin induced diabetes. Biomed., 23: 299 (1975)Google Scholar
  70. 70.
    S.M. Mauer, M.S. Steffes, M. Chern and D. Brown, Mesangial uptake and processing of macromolecules in rats with diabetes mellitus. Lab. Invest., 41: 401 (1979)PubMedGoogle Scholar
  71. 71.
    M. Teschner, R.M. Schaefer, U. Heidland, A. Svarnas and A. Heidland, Proteinase activity in isolated glomeruli of diabetic and non-diabetic rats. Kidn. Int., 1989, in pressGoogle Scholar
  72. 72.
    B. Greisinger, C.J. Olbricht and K.M. Koch, Decreased activity of intralysosomal proteolytic enzymes as possibly relevant factor for tubular hypertrophy in the early diabetic kidney. Kidn. Int., 33: 376, Abstract (1988)Google Scholar
  73. 73.
    M.A. Nerurker, J.G. Satar and S.S. Katyare, Insulin dependent changes in lysosomal cathepsin D-activity in rat liver, kidney, brain and heart. Diabetologica, 31: 119 (1988)CrossRefGoogle Scholar
  74. 74.
    J.A. Luetscher, F.B. Kraemer, D.M. Wilson, H.C. Schwartz and M.B. Bryer-Ash, Increased plasma inactive renin in diabetes mellitus. N. Engl. J. Med., 312 (1985)Google Scholar
  75. 75.
    G- Öberg, R. Hällgren, L. Moberg and P. Venge, Bacterial proteins and neutral proteases in diabetes neutrophils. Diabetologia, 29: 426 (1986)PubMedCrossRefGoogle Scholar
  76. 76.
    A. Collier, M. Jackson, D. Bell, A.W. Patrick, D.M. Matthews, R.J. Young, B.F. Clarke and J. Dawes, Increased neutrophil elastase activity in Type 1 (in- sulin-dependent) diabetic patients. Diabetologia, 30: 509 (1987)Google Scholar
  77. 77.
    W.H. Hdrl and A. Heidland, Evidence for the participation of granulocyte proteinases on intradialytic catabolism. Clin. Nephrol., 21: 314 (1984)Google Scholar

Copyright information

© Plenum Press, New York 1989

Authors and Affiliations

  • August Heidland
    • 1
  • Markus Teschner
    • 1
  • Roland Schaefer
    • 1
  1. 1.Division of Nephrology, Department of Internal MedicineUniversity of WürzburgWürzburgGermany

Personalised recommendations