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Nephrol Dial Transplant (1992) 7: 487-492
© 1992 European Renal Association-European Dialysis and Transplant Association

research-article

Urinary protein excretion and renal function in young people with diabetes mellitus

U. Widstam-Attorps1, and U. Berg2

1Department of Renal Medicine, Karolinska Institute, Huddinge University Hospital Huddinge, Sweden 2Departments of Paediatric, Karolinska Institute, Huddinge University Hospital Huddinge, Sweden

Correspondence and offprint requests to: Correspondence and offprint requests to: U. Widstam-Attorps MD, Department of Renal Medicine, Huddinge University Hospital, S-141 86 Huddinge, Sweden.

To detect early renal involvement in young diabetic patients (IDDM), urinary protein excretion and renal function were examined in 110 patients aged 5.9–25.0 years. Clearances of inulin and PAH were determined as well as albumin (Alb), IgG, N-acetyl-ß-D-glucosaminidase (NAG) and creatinine (Cr) excretion rates (UV). The patients were grouped according to IDDM durastion (2–<<5, 5–10 and >> 10 years) and albumin excretion rate (non-albuminuria <<20, microalbuminuria 20–200, and albuminuria >>200µg/min per 1.73 m2). Four patients had overt albuminuria, 17 microalbuminuria (equally distributed among the duration groups). Grouped according to albumin excretion rate, the mean GFR was increased in those without albuminuria but ‘normalized’ in patients with microalbuminuria/albuminuria. Grouped according to albumin excretion rate and the duration of the disease, the non-albuminuric patients with IDDM for >> 10 years had a lower GFR than those with a shorter duration of IDDM. The patients with microalbuminuria/albuminuria and IDDM for << 5 years had a reduced GFR. Patients with increased NAG excretion rate had lower Na excretion rate, lower fractional Na excretion and greater creatinine excretion than those with normal NAG excretion. Albumin excretion correlated with IgG excretion, but also with NAG excretion. Our results suggest that early albuminuria in IDDM is of both glomerular and tubular origin. The hyperfiltration declines with increasing albumin excretion but also with the duration of the disease.

Keywords: albuminuria; childhood; diabetes mellitus; microalbuminuria; NAG excretion; renal haemodynamics


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