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- Title
Prevalence of raised sodium-lithium countertransport activity in type 1 diabetic patients.
- Authors
De Faria, José B. Lopes; Friedman, Rogério; Tariq, Taimur; Viberti, GianCarlo
- Abstract
The prevalence of raised Na+/Li+ countertransport (CT) activity (>0.41 mmol/liter RBC/hr) was assessed in 185 consecu- tive insulin-dependent diabetic patients attending an outpatient diabetic clinic. Normoalbuminuria was defined as an overnight albumin excre- tion rate (AER) of <20 &mug;min (N = 121), microalbuminuria as AER between 20 and 150 &mug/min (N = 35) and macroalbuminuria as AER ≥ 150 &mug/min (N = 29). The prevalence of elevated Na+/Li+CT (>0.41 mmol/liter RBC/hr) was 21.5, 42.8 and 51.7% (P = 0.0005), in patients with normo-, micro- and macroalbuminuria, respectively. In the whole group, Na+/Li+CT was significantly related to mean blood pressure (MBP: rs = 0.37, P < 0.001) and AER (rs = 0.38, P < 0.001). In a multiple regression analysis the significant correlates of AER, as a continuous variable, or of proteinuria (micro + macroalbuminuria), as a categorical variable, were Na+/Li+CT, MBP, duration of diabetes and glycosylated hemoglobin (HbA1). The frequency of normoalbuminuric patients with high Na+/Li+CT activity fell with duration of diabetes. The risk of proteinuria was significantly greater in patients with raised Na+/Li+CT compared to those with Na+/Li+CT within the normal range (odds ratio 3.8, 95% CI, 1.9 and 7.8). A relative excess of patients with proteinuria (micro + macroalbuminuria) was found in the group with elevated Na+/Li+CT and HbAl above the median value (8.05%)of the whole population (x² = 9.7, P <. 0.002). Elevated Na+/Li+CT activity is more prevalent in IDDM patients with proteinuria and is rare in long-standing normoalbuminuric patients; the risk of proteinuria tncreases with increasing Na+/Li+CT rates; blood glucose control and Na+/Li+CT appear to interact in determining proteinuria.
- Subjects
PEOPLE with diabetes; DIABETES clinics; BLOOD pressure; ALBUMINS; ALBUMINURIA; KIDNEY diseases
- Publication
Kidney International, 1992, Vol 41, Issue 4, p877
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/ki.1992.134