Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2001-2-2
pubmed:abstractText
In type 1 diabetes, increases in sodium-lithium countertransport (Na-Li CT), kidney volume (KV), and albumin excretion rate (AER) may precede the development of persistent microalbuminuria. Limited data exist on reversibility of these factors early in the evolution of diabetic nephropathy. A crossover design was used to study the separate effects of enalapril and intensive diabetes management (IDM) on Na-Li CT, KV and AER in 17 children and adolescents with type 1 diabetes (5-10 years duration) with large kidneys (>275 ml/1. 73 m(2)) and predominantly normoalbuminuria. Subjects were randomized to receive 3 months of either enalapril (0.25 mg/kg/day) or IDM, a 3-month washout, followed by the alternate treatment for 3 months. During IDM, HbA1c decreased 2.5% (pre 9.5+/-0.3% (mean+/-SE), post 7.0+/-0.1%, p<0.0001), but was unchanged while on enalapril (pre 8.8+/-0.3%, post 8.5+/-0.3%, p=0.1). A significant decrease in Na-Li CT was seen with IDM (pre 0.43+/-0.05, post 0.36+/-0.04 mmol/l RBC/h, p=0.006) but not angiotensin converting enzyme inhibition (ACE-i) (pre 0.39+/-0.04, post 0.38+/-0.04 mmol/RBC/h, p=0.4). Neither ACE-i nor IDM affected KV or AER. It is concerning that kidney enlargement does not appear reversible at this early stage in the pathogenesis of diabetic nephropathy, although our conclusions are limited by the short duration of intervention and small sample size. The reduction in Na-Li CT with IDM suggests this may be a potentially modifiable risk factor for diabetic nephropathy.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
1056-8727
pubmed:author
pubmed:issnType
Print
pubmed:volume
14
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
333-9
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:11120458-Adolescent, pubmed-meshheading:11120458-Albuminuria, pubmed-meshheading:11120458-Angiotensin-Converting Enzyme Inhibitors, pubmed-meshheading:11120458-Antiporters, pubmed-meshheading:11120458-Child, pubmed-meshheading:11120458-Cross-Over Studies, pubmed-meshheading:11120458-Diabetes Mellitus, Type 1, pubmed-meshheading:11120458-Diabetic Nephropathies, pubmed-meshheading:11120458-Enalapril, pubmed-meshheading:11120458-Female, pubmed-meshheading:11120458-Hemoglobin A, Glycosylated, pubmed-meshheading:11120458-Humans, pubmed-meshheading:11120458-Hypertrophy, pubmed-meshheading:11120458-Kidney, pubmed-meshheading:11120458-Lithium, pubmed-meshheading:11120458-Male, pubmed-meshheading:11120458-Reference Values, pubmed-meshheading:11120458-Renin, pubmed-meshheading:11120458-Sodium
pubmed:articleTitle
Intensive diabetes management decreases Na-Li countertransport in young subjects with type 1 diabetes and enlarged kidneys.
pubmed:affiliation
Division of Endocrinology, The Hospital for Sick Children and University of Toronto, Toronto, Canada.
pubmed:publicationType
Journal Article, Clinical Trial, Randomized Controlled Trial, Research Support, Non-U.S. Gov't