PMID: 9536925Apr 16, 1998Paper

Angiotensin-converting enzyme inhibition does not correct early defects in renal and vascular permeability in diabetes mellitus

Clinical Science
R ZietseM A Schalekamp

Abstract

1. In diabetes mellitus a selective increase in the excretion of albumin generally precedes the occurrence of demonstrable loss of glomerular size-selectivity. However, even in this (microalbuminuric) phase of diabetic nephropathy a defect in glomerular barrier function can be demonstrated during infusion of atrial natriuretic peptide. 2. The aim of this study was to investigate whether angiotensin-converting enzyme inhibition could prevent the proteinuric response to atrial natriuretic peptide in these patients. We performed infusions of atrial natriuretic peptide (0.01 microgram min-1 kg-1) in 10 patients with insulin-dependent diabetes mellitus and microalbuminuria (urinary albumin excretion 90 +/- 44 mg/day), both before and after 1 month of treatment with enalapril (20 mg once daily). 3. Despite a 40% reduction in proteinuria, angiotensin-converting enzyme inhibition did not prevent the atrial natriuretic peptide-induced increase in protein excretion. Both before and during angiotensin-converting enzyme inhibition, atrial natriuretic peptide infusion resulted in a significant increase in the fractional excretion of large dextran molecules, which is compatible with an increase in flow through large unrestrictive 'shunt' por...Continue Reading

Citations

Sep 7, 2000·Diabetic Medicine : a Journal of the British Diabetic Association·K McKennaC J Thompson
Apr 28, 2000·Diabetic Medicine : a Journal of the British Diabetic Association·K McKennaC J Thompson
Sep 6, 2000·Diabetic Medicine : a Journal of the British Diabetic Association·K McKennaC J Thompson
Aug 20, 2003·Diabetic Medicine : a Journal of the British Diabetic Association·K B MooreC J Thompson

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diabetes & Tolerance

Patients with type I diabetes lack insulin-producing beta cells due to the loss of immunological tolerance and autoimmune disease. Discover the latest research on targeting tolerance to prevent diabetes.