Vol. 10, No 1, 2003 pp. 36 - 40
UC 616.379-008.64
THE RELATIONSHIP BETWEEN THE RATES OF
URINARY ALBUMIN EXCRETION AND GLOMERULAR FILTRATION IN TYPE 1 DIABETES
MELLITUS PATIENTS
Milena Rajić1, Momčilo Bogićević1,
Slobodan Antić2, Slobodan Ilić1,
Marina Vlajković1, Marina Avramović3,
Vladisav Stefanović3
1Department of Nuclear Medicine
2Clinic of Endocrinology, Diabetes
and Metabolic Disorders
3Institute of Nephrology and Hemodialysis,
Faculty of Medicine Niš, Serbia
E-mail: mrajic@EUnet.yu
Summary. Background/Aim: Albuminuria is recognized as an early marker
of diabetic nephropathy, but glomerular hyperfiltration appears prior to
its development. The aim of this study was to assess relationship between
the rates of urinary albumin excretion and glomerular filtration in different
diabetic kidney disease stages of type 1 diabetes mellitus.
Methods: According to urinary albumin excretion rate and serum creatinine,
seventy patients with type 1 diabetes mellitus were classified into normoalbuminuric
(NA), microalbuminuric (MiA), macroalbuminuric (MaA) and chronic renal
failure (CRF) group. Their results were compared with those of 23 healthy
volunteers. Plasma clearance of 99mTc-DTPA
was used to estimate glomerular filtration rate.
Results: Mean clearance value of 99mTc-DTPA
was recorded as increased in NA group (p<0.005), unchanged in MiA group
and decreased in both MaA and CRF groups (p<0.0001). The relationship
analysis established a significant correlation between albumin excretion
rate and glomerular filtration rate only in MaA group (r = -0.588, p=0.008).
Conclusion: Related to urinary albumin excretion, glomerular filtration
rate alteration appears in the earlier stage and represents a more reliable
indicator of renal function impairment in diabetic kidney disease.
Key words: Type 1 diabetes mellitus, urinary albumin excretion
rate, glomerular filtration rate
ODNOS IZMEĐU BRZINE URINARNE EKSKRECIJE
ALBUMINA
I JAČINE GLOMERULSKE FILTRACIJE
KOD BOLESNIKA SA TIPOM 1 DIJABETES MELITUSA
Kratak sadržaj: Cilj ove studije je bio da se ispita odnos između
brzine urinarne ekskrecije albumina i jačine glomerulske filtracije u različitim
stadijumima dijabetesne bubrežne bolesti kod bolesnika sa tipom 1 dijabetes
melitus-a.
Prema brzini urinarne ekskrecije albumina i nivou serumskog kreatinina,
sedamdeset bolesnika sa tipom 1 dijabetes melitus-a raspoređeno je u grupu
sa normoalbuminurijom, mikroalbuminurijom, makroalbuminurijom i hroničnom
bubrežnom slabošću, dok je kontrolnu grupu činilo 23 zdravih ispitanika.
Jačina glomerulske filtracije procenjivana je plazmatskim klirensom 99mTc-DTPA
.
Srednja vrednost klirensa 99mTc-DTPA
bila je značajno povišena u bolesnika sa normoalbuminurijom (p<0,005),
neizmenjena u bolesnika sa mikroalbuminurijom i snižena u bolesnika sa
makroalbuminurijom i bubrežnom insuficijenciom (p<0,0001). Statistički
značajna korelacija između ekskrecije albumina urinom i glomerulske filtracije
dokazana je samo u makroalbuminuriji (r=-0,588 p=0,008).
Dobijeni rezultati su pokazali da se poremećaj glomerulske filtracije
javlja pre povećanja ekskrecije albumina urinom i da predstavlja pouzdaniji
indikator renalnog funkcionog oštećenja u dijabetesnoj bubrežnoj bolesti.
Ključne reči: Dijabetes melitus tip 1, brzina urinarne ekskrecije
albumina, jačina glomerulske filtracije
