Fioretto P, Trevisan R, Giorato C, De Riva C, Doria A, Valerio A, Semplicini A, Angeli P, Cipollina M R, Nosadini R
Istituto di Medicina Interna, Patologia Medica I., Policlinico Universitario, Padova, Italy.
J Diabet Complications. 1988 Jan-Mar;2(1):27-9. doi: 10.1016/0891-6632(88)90024-4.
Human kidney responds to a meat meal with an increase in glomerular filtration rate (GFR), but the mechanisms regulating kidney hemodynamics following protein intake are poorly understood in Type I insulin-dependent diabetes. In the present study we investigated GFR response to protein intake (600 gr/1.73 m2 meat meal) in nine normal subjects and 21 Type I insulin-dependent diabetic patients with normal albumin excretion rates as well as proximal tubular sodium reabsorption rates and distal sodium delivery (PRNa and DDNa). The same study was reperformed in normal subjects and diabetic patients, with less than a 5 year diabetes duration, following one week of indomethacin treatment. Normal subjects showed a 38% increase in GFR following protein intake, whereas diabetic patients showed a significantly lower response (18%, p less than 0.01). The response of GFR to protein challenge was negatively related to diabetes duration but not to baseline glomerular filtration rate. Indomethacin treatment completely prevented the protein induced GFR increase in normal subjects but not in diabetic patients. Sodium reabsorption rate was increased following protein challenge both at the proximal and distal tubular level, as was net natriuresis.(ABSTRACT TRUNCATED AT 250 WORDS)
人类肾脏对进食肉类后肾小球滤过率（GFR）的增加有反应，但在I型胰岛素依赖型糖尿病中，蛋白质摄入后调节肾脏血流动力学的机制仍知之甚少。在本研究中，我们调查了9名正常受试者和21名白蛋白排泄率正常、近端肾小管钠重吸收率和远端钠输送率（PRNa和DDNa）正常的I型胰岛素依赖型糖尿病患者对蛋白质摄入（600克/1.73平方米肉类餐）的GFR反应。在正常受试者和糖尿病病程小于5年的糖尿病患者中，在吲哚美辛治疗一周后重复进行相同的研究。正常受试者在摄入蛋白质后GFR增加38%，而糖尿病患者的反应明显较低（18%，p<0.01）。GFR对蛋白质刺激的反应与糖尿病病程呈负相关，但与基线肾小球滤过率无关。吲哚美辛治疗完全阻止了正常受试者中蛋白质诱导的GFR增加，但在糖尿病患者中则不然。蛋白质刺激后，近端和远端肾小管水平的钠重吸收率均增加，净钠排泄也增加。（摘要截短至250字）
