Nephropathy of type II diabetes: Evidence for hereditary factors?

摘要: Family studies point to an important genetic element in the genesis of diabetic nephropathy, but it is not known whether renal abnormalities are present prior onset diabetes. To address this issue we examined all consecutive patients suffering from type II diabetes with a duration more than 10 years who attended outpatient clinic. Ninety-four had 307 did not. All offspring were phenotypically normal (no hypertension, oral glucose tolerance, non-smoking) and agreed participate examined, 26 nephropathic 30 non-nephropathic parents. They compared matched for age, gender BMI non-diabetic parents as controls. We measured urinary albumin excretion under baseline conditions at several time points after ingestion 300 g cooked beef submaximal treadmill exercise, respectively. In addition, casual blood pressure, ambulatory alpha-1-microglobulin measured. Primary disease was excluded by clinical examination. Under conditions, median rate (AER; microgram/min) significantly (P < 0.005) higher (7.8; range 1.04 19.5) (4.8; 0.36 17.5) controls (4.4; 0.16 18.4). Submaximal exercise caused greater proportional increase AER diabetics (median 16-fold) (6.3-fold) or (4.8-fold). particularly systolic pressures higher, correlated pressure. summary, values, albeit within range, postexercise albuminuria noted nephropathy. The observation suggests that changes transglomerular traffic demonstrable nephropathy subjects potential predisposition these conditions.