Nakamura R, Saruta T, Yamagami K, Saito I, Kondo K, Matsuki S
J Am Geriatr Soc. 1978 Jan;26(1):17-21. doi: 10.1111/j.1532-5415.1978.tb01949.x.
In order to study the role of the renin-angiotensin system in patients with diabetic nephropathy, renin release and the juxtaglomerular apparatus were studied in 17 diabetic patients with proteinuria and in 23 without proteinuria; 8 normal subjects were used for conctrls. Despite hypertension and marked arteriosclerosis, plasma renin activity (supine posture) was normal; however, the renin response to salt restriction and upright posture was less in the diabetic patients with proteinuria than in the controls. Renal renin content, determined at autopsy, was also normal. Examination of the juxtaglomerular apparatus in the diabetic patients with proteinuria revealed hyalinization of the afferent and efferent arterioles in most of the glomeruli and various degrees of destruction of the juxtaglomerular cells. The findings suggest that renin production is not increased in diabetic patients with proteinuria plus marked vascular damage, and that the renin-angiotensin system in patients with diabetic nephropathy apparently does not play an important role in the exacerbation of hypertension or the degree of vascular damage.
为了研究肾素 - 血管紧张素系统在糖尿病肾病患者中的作用，我们对17例有蛋白尿的糖尿病患者和23例无蛋白尿的糖尿病患者进行了肾素释放及球旁器的研究；8名正常受试者作为对照。尽管存在高血压和明显的动脉硬化，但血浆肾素活性（仰卧位）正常；然而，有蛋白尿的糖尿病患者对限盐和直立位的肾素反应低于对照组。尸检测定的肾脏肾素含量也正常。对有蛋白尿的糖尿病患者球旁器的检查发现，大多数肾小球的入球小动脉和出球小动脉玻璃样变，球旁细胞有不同程度的破坏。这些发现提示，有蛋白尿且伴有明显血管损伤的糖尿病患者肾素生成并未增加，糖尿病肾病患者的肾素 - 血管紧张素系统显然在高血压的加重或血管损伤程度方面不起重要作用。
