Atrial natriuretic factor [ANF] in type II diabetics: relationship to hypertension and nephropathy

Sixty-three non-insulin dependent diabetic patients, 11 healthy normotensive volunteers and 10 non-diabetic hypertensive men were included in this work. For all members of the study, a morning urine sample was collected without a preservative, centrifuged, and the supernatant was test for macroalbuminuria by albustix and the creatinine was determined by alkaline picrate reaction. Microalbuminuria was also determined by a double antibody 125I radioimmunoassay. Fasting blood sample was also taken from each individual and the serum was separated and the atrial natriuretic factor [peptide] was assayed by a competitive radioimmunoassay. The results revealed a highly significant increase in ANF levels in the whole diabetic group as compared with non-diabetic one and this increase of ANF in diabetics has been explained by the volume expansion associated with hyperglycemia and that raised plasma ANF could contribute to the glomerular hyperfiltration characteristics of early diabetes

Evaluation of renal glomerular and tubular markers in type I diabetics without clinical proteinuria and relation to B-cell function

To evaluate the value of microalbuminuria, urinary B2 microglobulin [B2M] and urinary N-acetyl B-D-glucosaminase [NAG] in the assessment of renal glomerular and/or tubular impairment in type 1-insulin dependent diabetic patients without clinical proteinuria and to try to clarify the relationship of these parameters with the occurrence of diabetic nephropathy and with the pancreatic B-cell function; 30 insulin dependent diapetic patients and 10 healthy normal controls were selected. Urinary C-peptide was measured in 2 hours urine collection after oral glucose load. Serum and urinary B2M, microalbuminria, urinary NAG, serum and urine creatinine and blood glucose were measured to both subjects and controls. A significant reduction in the level of C-peptide among diabetics was evident [P < 0.001]. A highly significant increase in microalbuminuria urinary B2M and urinary NAG was observed in diabetics[P < 0.001]. The incidence of abnormal increase in microalbuminuria was 80%, urinary B2M was 73. 3% and urinary NAG was 46. 67%. Mixed type proteinuria with high levels of both microalbuminuria and B2M was observed in 59.97% of diabetics. Microalbuminria was inversely related to urinary C-peptide. These data suggests that an early impairment might develop in glomeruli and/or tubules in type 1 diabetics before the occurrence of overt nephropathy and the measurement of Microalbuminria, urinary B2M and NAG are reliable methods to detect this early damage before the development of irreversible diabetic nephropathy

Microalbuminuria of incipient nephropathy in type 2 diabetics: Effect of pentoxifylline

Twenty six non insulin dependent diapetic [NIDD] patients and ten healthy controls are included in the present work. To all subjects included in the study, urine analysis for clinical proteinuria has been done. None of the diabetics have overt nephropathy [all with normal serum creatinine and no macroalbuminuria]. All patients have neither pyuria, nor evidence of cardiovascular disease. All patients are maintained on the same oral hypoglycaemic drug previously taken before the study. Fasting and two hours postprandial blood glucose, serum creatinine, urinary creatinine, microalbuminuria in ug albumin/mg urinary creatinine were determined to all subjects and contrals. Trental was adminstered in a dose of 800 mg for fifteen days to all diabetics and all the parameters are determined after the drug intake. The results revealed no significant change in microalbuminuria after pentoxifylline [Trental] therapy. However, individual data revealed that in twelve diabetics the microalbuminuria decreased and in fourteen diabetics the microalbuminuria increased after Trental. The increase in microalbuminuria has been explained on the basis of the mechanism of action of Trental on large vessels of the kidney while the decreasing effect of Trental on the microalbuminuria is probably due to its action on the red cell rheology with improvement of the microcirculation. The work clarifies that Trental has neither deleterious effect on the kidney function nor on the glucose tolerance. It is sugggested that Trental is useful on long term use in incipient diabetic nephropathy