Exogenous norepinephrine induces an enhanced microproteinuric response in microalbuminuric insulin-dependent diabetes mellitus.

Journal of the American Society of Nephrology : JASN
K HoogenbergR P Dullaart

Abstract

Exogenous norepinephrine (NE) increases intraglomerular pressure in animal experiments, but it is unknown whether NE induces a microproteinuric response in humans. Moreover, it has not been studied whether possible microproteinuric and renal hemodynamic changes induced by NE are altered in insulin-dependent diabetes mellitus (IDDM) complicated by microalbuminuria. Therefore, the microproteinuric and renal hemodynamic responses to exogenous NE infusions were measured in eight matched normoalbuminuric IDDM patients (group D1), microalbuminuric IDDM patients (group D2), and control subjects (group C). As anticipated, mean arterial pressure (MAP)-NE dose-response curves were significantly shifted leftward in groups D1 and D2 compared with group C (P < 0.05), indicating a higher systemic NE responsiveness in IDDM. On separate days, NE or placebo was infused at individually determined NE threshold doses (T; delta MAP = 0 mmHg), 20% pressor doses (20% P; delta MAP = 4 mmHg), and pressor doses (P; delta MAP = 20 mmHg), with measurement of urinary albumin (UalbV), IgG excretion (UIgGV), GFR (by 125I-iothalamate), and effective renal plasma flow (by 131I-hippurate). At NE pressor dose, UalbV and UIgGV rose in all groups (P < 0.05 to 0.01...Continue Reading

Citations

May 20, 2003·Kidney International·Merlin C ThomasPhillip Kantharidis
Sep 8, 2006·The Journal of Clinical Hypertension·Francisco J Mena-MartínUNKNOWN Hortega Study Investigators
Mar 28, 2007·Intensive Care Medicine·Yoshiaki TeraoKoji Sumikawa
Oct 9, 2009·Clinical and Experimental Hypertension : CHE·Ai NagaeToshiro Fujita
May 1, 2010·Annals of Medicine·Riitta SallinenUNKNOWN Finnish Diabetic Nephropathy Study Group

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