Short-term moderate sodium restriction induces relative hyperfiltration in normotensive normoalbuminuric Type I diabetes mellitus |
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Authors: | Luik P T Hoogenberg K Van Der Kleij F G H Beusekamp B J Kerstens M N De Jong P E Dullaart R P F Navis G J |
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Institution: | (1) Department of Medicine, Division of Nephrology, University Hospital, Groningen, The Netherlands, NL;(2) Department of Medicine, Division of Endocrinology, University Hospital Groningen, The Netherlands, NL;(3) Department of Medicine, Division of Dietetics, University Hospital Groningen, The Netherlands, NL |
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Abstract: | Aims/hypothesis. Type I (insulin-dependent) diabetes mellitus is associated with an increased extracellular volume. Sodium restriction might
seem a logical form of treatment but data on its renal effects is conflicting. We therefore studied the effects of sodium
restriction on renal haemodynamics in uncomplicated Type I diabetes mellitus. Methods. Uncomplicated Type I diabetic patients (n = 24) and matched control subjects (n = 24) were studied twice in random order: after a week of 50 mmol or after 200 mmol sodium intake, respectively. The diabetic
patients were studied under normoglycaemic clamp conditions. Glomerular filtration rate and effective renal plasma flow were
measured as the clearances of iothalamate and hippuran, respectively. Results. During liberal sodium intake, glomerular filtration, effective renal plasma flow and filtration fraction were similar between
the diabetic patients and the control subjects. Sodium restriction decreased the effective renal plasma flow in both groups,
whereas glomerular filtration rate only decreased in the control subjects. Consequently, in the diabetic patients, the filtration
fraction was increased on low sodium (4.1 ± 8.4 %, p < 0.05 vs liberal sodium). As a consequence, filtration fraction (24.0 ± 2.6 vs 22.1 ± 2.0 %, p < 0.05) and glomerular filtration (119 ± 14 vs 110 ± 13 ml/min, p < 0.05) were higher in the diabetic patients than in the control subjects during sodium restriction. Conclusion/interpretation. Short-term moderate sodium restriction induces relative hyperfiltration in uncomplicated Type I diabetes. This could indicate
an increased intraglomerular pressure. Sodium restriction could be an unfavourable preventive approach in diabetes mellitus
but its long-term effects are not known. Diabetologia (2002) 45: ▪–▪]
Received: 17 September 2001 and in revised form: 7 November 2001 |
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Keywords: | Type I diabetes mellitus sodium intake renal haemodynamics renin-angiotensin system diabetic nephropathy |
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