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document
Acute reduction of arterial blood pressure reduces urinary albumin excretion in type 1 ( insulin-dependent ) diabetic patients with incipient nephropathy . The effect of an acute reduction in arterial blood pressure upon kidney function was studied in 12 patients with Type 1 ( insulin-dependent ) diabetes and incipient nephropathy ( persistent microalbuminuria ) . Renal function was assessed by measurement of the glomerular filtration rate ( single bolus 51Cr-EDTA technique ) and by the urinary albumin excretion rate ( radioimmunoassay ) . The study was performed twice within 2 weeks , with the patients receiving a slow intravenous injection of either clonidine ( 225 micrograms ) or saline ( 154 mmol/l ) in random order . Clonidine reduced arterial blood pressure from 125/79 +/- 13/8 to 104/68 +/- 9/7 mmHg ( p less than 0.01 ) , urinary albumin excretion rate from 68 ( 31-369 ) to 46 ( 6-200 ) micrograms/min ( median and range ) ( p less than 0.01 ) , and fractional clearance of albumin in all patients ( median 29 % ) ( p less than 0.01 ) . Glomerular filtration rate was 110 +/- 11 before and 106 +/- 13 ml/min/1.73 m2 after clonidine injection . The blood glucose concentration was 15 +/- 4 mmol/l before and 14 +/- 5 mmol/l after clonidine injection . In agreement with findings in animal studies , our results suggest that microalbuminuria is to a large extent pressure-dependent , probably because of glomerular hypertension , and that autoregulation of glomerular filtration rate is normal in most patients with incipient diabetic nephropathy .
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Intervention_Pharmacological
clonidine
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Intervention_Pharmacological
saline
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Intervention_Pharmacological
Clonidine
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Intervention_Pharmacological
clonidine
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Intervention_Pharmacological
clonidine
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Outcome_Physical
urinary albumin excretion
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Outcome_Physical
kidney function
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Outcome_Physical
Renal function
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Outcome_Physical
glomerular filtration rate
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Outcome_Physical
urinary albumin excretion rate ( radioimmunoassay ) .
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Outcome_Physical
arterial blood pressure
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Outcome_Physical
urinary albumin excretion rate
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Outcome_Physical
fractional clearance of albumin
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Outcome_Physical
Glomerular filtration rate
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Outcome_Physical
blood glucose concentration
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Outcome_Physical
glomerular filtration rate
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Participant_Condition
type 1 ( insulin-dependent ) diabetic patients with incipient nephropathy .
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Participant_Condition
12 patients with Type 1 ( insulin-dependent ) diabetes and incipient nephropathy ( persistent microalbuminuria ) .