A correlation between the renal functional reserve and glomerular filtration rate in patients with type 2 diabetes

• Дата: 2015
• Автори: Kuznetsova, E.S., Kuznetsov, S.G., Bobryk, L.M., Shukhtin, V.V., Gozhenko, A.I.
• Формат: Стаття
• Мова: English
• Опубліковано: Фізико-хімічний інститут ім. О.В. Богатського НАН України 2015
• Назва видання: Актуальні проблеми транспортної медицини
• Теми: Экспериментальные исследования
• Онлайн доступ: http://dspace.nbuv.gov.ua/handle/123456789/136571
• Назва журналу: Digital Library of Periodicals of National Academy of Sciences of Ukraine
• Цитувати: A correlation between the renal functional reserve and glomerular filtration rate in patients with type 2 diabetes / E.S. Kuznetsova, S.G. Kuznetsov, L.M. Bobryk, V.V. Shukhtin, A.I Gozhenko // Актуальні проблеми транспортної медицини. — 2015. — № 1 (39). — С. 161-166. — Бібліогр.: 12 назв. — англ.

Research aim: to study correlation between the renal functional reserve and glomerular filtration rate in patients with a diabetes mellitus 2 types. Patients and methods. 40 patients, 14 men (35 %) and the 26th women (65 %) took part in research, aged from 39-76 years whom were estimated the level of НВА₁с, renal excretion of albumin and albumin-to-creatinine ratio, fixed abnormal changes in a urinary sediment and serum concentration of creatinine, glomerular filtration rate using the formula of GFR – EPI, and glomerular filtration rate after water-salt load of 0.5 % NaCl determined by clearance of creatinine followed by using them to determine a renal functional reserve. Discussion results. Depending on the level of GFR, which ranged from 32 to 97 ml/ min, all patients were divided into 3 groups — 3 patients (7.5 %) with GFR > 90 ml/min, 22 patients (55 %) with GFR 60 89 ml/min and 15 patients (37.5 %) with GFR 30-59 ml/ min. In all 15 patients (37.5 %) the declines in glomerular filtration rate from 30 to 59 ml/ min were combined with the value of renal functional reserve varied from 16 to 500 %, averaged to 325 + 17 %, concurrently, the hypercreatinemia ranged from 98 to 137 mmol/l in 12 patients (80 %) and albuminuria varied from 0.03 to 0.08 g/l and from 3.6 to 43.8 mg/mmol creatinine in 6 patients (40 %). At the same time, in 2 patients with estimated GFR > 90 ml/min, the total normal glomerular filtration rate was maintained by the nephrons hyperfiltration near its maximum functional operating limit in spite of the complete absence of kidney damage and good glycemic control. So during the water-salt load, these hidden abnormalities were manifested as a high urinary albumin excretion reached 26.7 mg/mmol creatinine and negative value of renal functional reserve varied from -6 to -8 %. Conclusion. Direct correlation between glomerular filtration rate and functioning parenchyma mass was not found.