Pathogenesis of Diabetic Glomerulopathy: The Role of Glomerular Hyperfiltration

  • Sharon Anderson
  • Barry M. Brenner
Part of the Topics in Renal Medicine book series (TIRM, volume 6)


More than half a century ago, Cambier [1] made the seemingly paradoxical observation that diabetics, a group well represented in contemporary hemodialysis units, frequently exhibit striking elevations in glomerular filtration rate (GFR) at the time of diagnosis. Glomerular hyperfiltration in type 1 diabetics has since been documented by using newer measurement techniques [2–5]. Although initial studies of human diabetics indicated that hyperfiltration was not consistently associated with increments in renal plasma flow [2], more recent evidence suggests that such increments are indeed present and are usually accompanied by a substantial increase in kidney size [4]. The finding of early hyperfiltration was confirmed by Stalder and Schmid [5], who in 1959 proposed the hypothesis that early changes in renal function might relate to the morphologic injury that eventuates in diabetic patients. Indeed, modern studies have confirmed that those patients with persistent hyperfiltration are more likely to progress to persistent proteinuria or overt diabetic nephropathy than are those patients with less elevated initial values for GFR [6].


Glomerular Filtration Rate Diabetic Nephropathy Renal Plasma Flow Glomerular Hyperfiltration Plasma Atrial Natriuretic Peptide 
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© Springer Science+Business Media Dordrecht 1988

Authors and Affiliations

  • Sharon Anderson
  • Barry M. Brenner

There are no affiliations available

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