According to modern concepts of the initiation and progression of nonimmunological renal disease, the increased leakage of plasma proteins through the glomerular wall and their mesangial uptake represents a decisive event in the natural history of diabetic nephropathy. Two mechanisms provide the pathogenetic background for increased protein (mainly albumin) leakage in diabetes mellitus: (1) Hemodynamic changes due to elevated microcirculation hydrostatic pressure and (2) Metabolic factors which are supposed to act by altering the renal selectivity properties toward glycated proteins. Accordingly, it has been demonstrated that antihypertensive treatment considerably retards the progression of diabetic nephropathy and also a significant improvement of albuminuria has been obtained by the amelioration of metabolic control of microalbuminuric diabetics achieved by continuous subcutaneous insulin infusion. We have tried to investigate the possible connections between the two physiopathological factors by following in micro and macroalbuminuric diabetics the changes in renal selectivity properties toward glycated albumin (GA) (the metabolic factor) induced by arterial hypertension (AH) (the hemodynamic factor).
|Number of pages||2|
|Publication status||Published - 1986|
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