Semplicini A, Angeli P, Nosadini R, Trevisan R, Fioretto P, Doria A, Rigon E, Sama B
Clinica Medica I, University of Padova, Italy.
Diabetes Res. 1989 Jun;11(2):67-72.
It has been reported that patients with type I insulin dependent diabetes mellitus (IDDM) are characterized by reduced Na+ excretion during water immersion and saline infusion and abnormal glomerulo-tubular balance. Aims of the present study were therefore to investigate firstly the fractional tubular Na+ reabsorption during saline infusion to clarify the altered tubular site and secondly the glomerulo-tubular balance during acute increase of glomerular filtration rate induced by sodium acetoacetate infusion in IDDM. During saline and euglycaemic glucose clamp, after an overnight fast, glomerular filtration rate, renal plasma flow, filtration fraction and plasma sodium were 99 +/- 15 ml min-1 1.73 m-2, 452 +/- 109 ml min-1 1.73 m-2, 0.23 +/- 0.04 and 142 +/- 8 mmol l-1 (Mean +/- SD) in 10 type I insulin dependent diabetic patients and 96 +/- 18, 452 +/- 87, 0.21 +/- 0.02, 143 +/- 2 in five matched normal subjects, respectively. The lithium and sodium clearances were significantly lower in diabetic patients than in normal subjects (23 +/- 5 ml min-1 1.73 m-2 vs 28 +/- 6, p less than 0.05 and 1.1 +/- 0.4 vs 1.6 +/- 0.3, p less than 0.01 respectively). The fractional lithium reabsorption was greater (0.77 +/- 0.04 vs 0.72 +/- 0.03, p less than 0.05) and the distal fractional sodium reabsorption smaller (0.22 +/- 0.04 vs 0.27 +/- 0.03, p less than 0.01) in the diabetic patients compared to the controls.(ABSTRACT TRUNCATED AT 250 WORDS)
据报道，I型胰岛素依赖型糖尿病（IDDM）患者的特征是在水浸和盐水输注期间钠排泄减少以及肾小球-肾小管平衡异常。因此，本研究的目的首先是研究盐水输注期间肾小管钠重吸收分数，以阐明肾小管部位的改变，其次是研究IDDM患者中由乙酰乙酸钠输注引起的肾小球滤过率急性增加期间的肾小球-肾小管平衡。在禁食过夜后的盐水和正常血糖葡萄糖钳夹期间，10例I型胰岛素依赖型糖尿病患者的肾小球滤过率、肾血浆流量、滤过分数和血浆钠分别为99±15 ml·min⁻¹·1.73 m⁻²、452±109 ml·min⁻¹·1.73 m⁻²、0.23±0.04和142±8 mmol·l⁻¹（均值±标准差），5例匹配的正常受试者分别为96±18、452±87、0.21±0.02、143±2。糖尿病患者的锂清除率和钠清除率显著低于正常受试者（分别为23±5 ml·min⁻¹·1.73 m⁻²对28±6，p<0.05；1.1±0.4对1.6±0.3，p<0.01）。与对照组相比，糖尿病患者的锂重吸收分数更高（分别为0.77±0.04对0.72±0.03，p<0.05），远端钠重吸收分数更小（0.22±0.04对0.27±0.03，p<0.01）。（摘要截断于250字）
