caa a22 4500 475773098 CHVBK 20180406123623.0 cr unu---uuuuu 170329e20000201xx s 000 0 eng 10.1007/s001250050033 doi (NATIONALLICENCE)springer-10.1007/s001250050033 Contrasting renal functional reserve in very long-term Type I diabetic patients with and without nephropathy [Elektronische Daten] [H. Sackmann, T. Tran-Van, I. Tack, H. Hanaire-Broutin, J.-P. Tauber, J.-L. Ader] Aims. This study was to determine whether renal functional reserve (RFR) is present in patients who have suffered long-lasting Type I (insulin-dependent) diabetes mellitus.¶Methods. Renal functional reserve was elicited by a 3-h amino acid infusion (4.5 mg · kg-1· min-1) in 10 patients with nephropathy (DN +) and 10 patients without nephropathy (DN-) who had lived with diabetes for 24 ± 3 and 27 ± 3 years, respectively and in 15 healthy control subjects. Renal functional reserve was calculated as the difference between amino acid-stimulated and baseline glomerular filtration rates (GFR).¶Results. Baseline glomerular filtration rate in DN- patients (106 ± 8) and control subjects (112 ± 3 ml · min-1· (1.73m2)-1) was significantly higher (p < 0.01) than in DN + patients (79 ± 7 ml · min-1· (1.73m2)-1). Renal functional reserve was absent in DN + patients, whereas it represented 26 ± 4 % of the baseline in DN- patients and 23 ± 2 % in control subjects. Renal vascular resistance decreased statistically significantly during amino acid infusion in DN- patients and control subjects but not in DN + patients.¶Conclusions/hypothesis. These results indicate that very long-term Type I diabetic patients without diabetic nephropathy still have a normal renal functional reserve. In contrast, this reserve is suppressed in similarly long-term macroalbuminuric and hypertensive patients with overt nephropathy in spite of their remarkably maintained glomerular filtration rate. This opposite impairment supports the interpretation that glomerular hyperfiltration is a determining mechanism in human diabetic nephropathy. [Diabetologia (2000) 43: 227-230] Springer-Verlag Berlin Heidelberg, 2000 Keywords Type I diabetes, diabetic nephropathy, renal functional reserve, amino acid infusion, glomerular hyperfiltration nationallicence Sackmann H. Diabetology and Endocrinology Department, Rangueil University Hospital, Toulouse, France, FR aut Tran-Van T. Kidney Clinical Investigation Laboratory and INSERM Unit 388, Rangueil University Hospital, Toulouse, France, FR aut Tack I. Kidney Clinical Investigation Laboratory and INSERM Unit 388, Rangueil University Hospital, Toulouse, France, FR aut Hanaire-Broutin H. Diabetology and Endocrinology Department, Rangueil University Hospital, Toulouse, France, FR aut Tauber J.-P Diabetology and Endocrinology Department, Rangueil University Hospital, Toulouse, France, FR aut Ader J.-L Kidney Clinical Investigation Laboratory and INSERM Unit 388, Rangueil University Hospital, Toulouse, France, FR aut https://doi.org/10.1007/s001250050033 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s001250050033 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sackmann H. Diabetology and Endocrinology Department, Rangueil University Hospital, Toulouse, France, FR aut NATIONALLICENCE 700 1- Tran-Van T. Kidney Clinical Investigation Laboratory and INSERM Unit 388, Rangueil University Hospital, Toulouse, France, FR aut NATIONALLICENCE 700 1- Tack I. Kidney Clinical Investigation Laboratory and INSERM Unit 388, Rangueil University Hospital, Toulouse, France, FR aut NATIONALLICENCE 700 1- Hanaire-Broutin H. Diabetology and Endocrinology Department, Rangueil University Hospital, Toulouse, France, FR aut NATIONALLICENCE 700 1- Tauber J.-P Diabetology and Endocrinology Department, Rangueil University Hospital, Toulouse, France, FR aut NATIONALLICENCE 700 1- Ader J.-L Kidney Clinical Investigation Laboratory and INSERM Unit 388, Rangueil University Hospital, Toulouse, France, FR aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer