Bognetti E, Meschi F, Bonfanti R, Gianolli L, Chiumello G
Scientific Institute H San Raffaele, Milano, Italy.
Diabetes Care. 1993 Jan;16(1):120-4. doi: 10.2337/diacare.16.1.120.
This study has been designed to follow prospectively the GFR and UAE of young patients with short-term IDDM and normal UAE.
The study population consisted of 19 patients with glomerular hyperfiltration and 19 patients with normal GFR, matched for duration of diabetes and age. GFR has been assessed by radioisotopic tracer and UAE by RIA at the beginning of the study and after 30.5 +/- 10.4 mo of follow-up.
GFR decreased in the two groups btt delta GFR of patients with glomerular hyperfiltration was greater than delta GFR of patients with normal GFR (0.83 +/- 0.55 vs. 0.28 +/- 0.63 ml.min-1.mo-1; P < 0.01). UAE, BP, and prevalence of microalbuminuria were comparable between the two groups at follow-up. Rate of fall of GFR was positively correlated with initial GFR (r = 0.59, P < 0.001) but not with initial UAE, BP, or changes in HbA1C, UAE, BP, or pubertal development during follow-up.
Investigation of kidney function in children and adolescents with IDDM over a 3-yr follow-up period shows that glomerular hyperfiltration is characterized by a greater decline in GFR without an increased rate of appearance of microalbuminuria, than in patients with normal GFR.
本研究旨在对短期患胰岛素依赖型糖尿病且尿白蛋白排泄率（UAE）正常的年轻患者的肾小球滤过率（GFR）和UAE进行前瞻性跟踪研究。
研究人群包括19例肾小球高滤过患者和19例GFR正常的患者，根据糖尿病病程和年龄进行匹配。在研究开始时以及随访30.5±10.4个月后，通过放射性同位素示踪剂评估GFR，通过放射免疫分析法评估UAE。
两组的GFR均下降，但肾小球高滤过患者的ΔGFR大于GFR正常患者的ΔGFR（0.83±0.55对0.28±0.63 ml·min⁻¹·月⁻¹；P<0.01）。随访时两组间的UAE、血压和微量白蛋白尿患病率相当。GFR下降速率与初始GFR呈正相关（r = 0.59，P<0.001），但与初始UAE、血压或随访期间糖化血红蛋白（HbA1C）、UAE、血压或青春期发育的变化无关。
对患胰岛素依赖型糖尿病的儿童和青少年进行3年随访期的肾功能研究表明，与GFR正常的患者相比，肾小球高滤过的特征是GFR下降幅度更大，而微量白蛋白尿出现率并未增加。
