ter Wee P M, van Ballegooie E, Rosman J B, Meijer S, Donker A J
Diabetologia. 1986 Feb;29(2):78-81. doi: 10.1007/BF00456114.
It is well known that patients with Type 1 (insulin-dependent) diabetes exhibit both increased glomerular filtration rate and effective renal plasma flow, which can be found even when these patients are well controlled. Usually this is attributed to a decrease in renal vascular resistance and/or to enlarged kidney size and glomerular volume. Among the factors which govern glomerular filtration rate, renal plasma flow is most important. Renal plasma flow increases if renal vascular resistance decreases. The latter might exist in insulin-dependent diabetes mellitus because of either a predominantly afferent or a predominantly efferent vasodilatation. Dopamine is an agent which causes predominantly efferent vasodilatation. Therefore, the effects of infusing a low dose of dopamine on glomerular filtration rate and effective renal plasma flow in 12 well-controlled patients with Type 1 (insulin-dependent) diabetes and 28 healthy volunteers were compared to investigate whether the increased glomerular filtration rate in Type 1 diabetes is caused by an efferent vasodilatation. The median increase in glomerular filtration rate during dopamine infusion amounted to 13.0% in diabetic patients and 12.5% in healthy control subjects (n.s.). It is concluded that the elevated glomerular filtration rate in well-controlled Type 1 diabetes is not caused by a predominantly efferent vasodilatation.
众所周知，1型（胰岛素依赖型）糖尿病患者的肾小球滤过率和有效肾血浆流量均会增加，即便这些患者病情得到良好控制时也是如此。通常认为，这是由于肾血管阻力降低和/或肾脏大小及肾小球体积增大所致。在影响肾小球滤过率的诸多因素中，肾血浆流量最为重要。如果肾血管阻力降低，肾血浆流量就会增加。后者在胰岛素依赖型糖尿病中可能存在，原因可能是主要为入球小动脉或主要为出球小动脉的血管舒张。多巴胺是一种主要引起出球小动脉血管舒张的物质。因此，比较了对12例病情得到良好控制的1型（胰岛素依赖型）糖尿病患者和28名健康志愿者输注低剂量多巴胺对肾小球滤过率和有效肾血浆流量的影响，以研究1型糖尿病患者肾小球滤过率升高是否由出球小动脉血管舒张引起。糖尿病患者在输注多巴胺期间肾小球滤过率的中位数增幅为13.0%，健康对照受试者为12.5%（无显著差异）。得出的结论是，病情得到良好控制的1型糖尿病患者肾小球滤过率升高并非主要由出球小动脉血管舒张所致。
