[Relationship between elevated plasma endothelin-1 level and renal function in patients with diabetic nephropathy].

Plasma endothelin-1 (ET-1) level was measured with radioimmunoassay in 33 normal subjects and 92 patients with different stages of diabetic nephropathy, consisting of 35 cases of diabetes mellitus with normal urinary albumin excretion (DM), 22 cases of incipient diabetic nephropathy (IDN), 22 cases of overt diabetic nephropathy (ODN), 8 cases with azotemia (DNa) and 5 cases with uremia (DNu). The results showed that plasma ET-1 levels in DNa and DNu groups (30.24 +/- 1.93 ng/L and 36.38 +/- 3.62 ng/L respectively) were significantly higher than those in other groups (P < 0.05); ET-1 level in ODN group (20.50 +/- 0.93 ng/L) was significantly higher than those in DM and IDN groups (P < 0.001); ET-1 level in IDN group was also significantly higher than that in DM group (17.79 +/- 0.74 vs. 15.06 +/- 0.63 ng/L, P < 0.01); All the above values were significantly higher than that in normal subjects (7.08 +/- 0.22 ng/L) (P < 0.001). There was significant positive correlation between ET-1 level and HbA1c, systolic pressure, diastolic pressure, blood urea nitrogen, serum creatine, uAER and a significant negative correlation between ET-1 level and glomerular filtration rate. It is shown that progressive elevation of plasma ET-1 level is closely related with different stages of renal function impairment, suggesting strongly the role of ET-1 in the development and progression of diabetic nephropathy.