Pathogenesis of Diabetic Glomerulopathy: The Role of Glomerular Hemodynamic Factors

  • Jiten P. Vora
  • Sharon Anderson
  • Barry M. Brenner
Chapter

Abstract

Glomerular hyperfiltration in insulin-dependent (type 1) diabetes mellitus (IDDM) has been recognized for many years [1–3], with increments in renal plasma flow (RPF) and nephromegaly [3]. With the finding of hyperfiltration, Stalder and Schmid proposed that these early functional changes may predispose the subsequent development of diabetic glomerulopathy [1]. Early support for the hypothesis that renal hyperperfusion and hyperfiltration contribute to diabetic glomerulopathy emanated from the finding of diabetic glomerulopathy only in the non-stenosed kidney in the setting of unilateral renal artery stenosis [4].

Keywords

Atrial Natriuretic Peptide Experimental Diabetes Renal Plasma Flow Glomerular Hyperfiltration Tubuloglomerular Feedback 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Stalder G, Schmid R. Severe functional disorders of glomerular capillaries and renal hemodynamics in treated diabetes mellitus during childhood. Ann Paediatr 1959; 193: 129–138PubMedGoogle Scholar
  2. 2.
    Ditzel J, Junker K. Abnormal glomerular filtration rate, renal plasma flow and renal protein excretion in recent and short-term diabetes. BMJ 1972; 2: 13–19.PubMedCrossRefGoogle Scholar
  3. 3.
    Mogensen CE, Andersen MJF. Increased kidney size and glomerular filtration rate in early juvenile diabetes. Diabetes 1973; 22: 706–712.PubMedGoogle Scholar
  4. 4.
    Berkman J, Rifkin H. Unilateral nodular diabetic glomerulosclerosis (Kimmelstiel Wilson). Metabolism 1973; 22: 715–722.PubMedCrossRefGoogle Scholar
  5. 5.
    Vora J, Dolben J, Dean J, Williams JD, Owens DR, Peters JR. Renal hemodynamics in newly presenting non-insulin-dependent diabetics. Kidney Int 1992; 41: 829–835.PubMedCrossRefGoogle Scholar
  6. 6.
    Myers BD, Nelson RG, Williams GW, et al. Glomerular function in Pima Indian with non-insulin-dependent diabetes mellitus of recent origin. J Clin Invest 1991; 88: 524–530.PubMedCrossRefGoogle Scholar
  7. 7.
    Palmisano JJ, Lebovitz HE. Renal function in Black Americans with type II diabetes. J Diabetic Complications 1989; 3: 40–44.CrossRefGoogle Scholar
  8. 8.
    Nelson RG, Beck GJ, Bennett PH, Knowler WC, Mitch WE, Myers BD. Changes in glomerular function with the onset of non-insulin-dependent diabetes in Pima Indians. Diabetologia 1993; 36: A27 (abstr).Google Scholar
  9. 9.
    Mogensen CE. Early glomerular hyperfiltration in insulin-dependent diabetics and late nephropathy. Scand J Clin Lab Invest 1986; 46: 201–206.PubMedCrossRefGoogle Scholar
  10. 10.
    Rudberg S, Persson B, Dahlquist G. Increased glomerular filtration rate as a predictor of diabetic nephropathy — an 8 year prospective study. Kidney Int 1992; 41: 822–828.PubMedCrossRefGoogle Scholar
  11. 11.
    Lervang H-H, Jensen S, Borchner-Mortensen J, Ditzel J. Early glomerular hyperfiltration and the development of late nephropathy in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 1988; 31: 723–729.PubMedCrossRefGoogle Scholar
  12. 12.
    Messent J, Jones SL, Wiseman M, Viberti GC. Glomerular hyperfiltration and albuminuria: an 8 year prospective study. Diabetologia 1991; 34: suppl. 2: 3A (abstr).Google Scholar
  13. 13.
    Vora JP, Peters JR, Williams JD. Evolution of renal hemodynamics in non-insulindependent diabetics (NIDDMs): a 2 year study. J Am Soc Nephrol 1993; 4: 310 (abstr).Google Scholar
  14. 14.
    Anderson S. Antihypertensive therapy in experimental diabetes. J Am Soc Nephrol 1992; 3: suppl. 1: 586–590.Google Scholar
  15. 15.
    O’Donnell MP, Kasiske BL, Keane WF. Glomerular hemodynamics and structural alterations in experimental diabetes. FASEB J 1986; 2: 2339–2347.Google Scholar
  16. 16.
    Hostetter TH, Troy JL, Brenner BM. Glomerular hemodynamics in experimental diabetes mellitus. Kidney Int 1981; 19: 410–415 .PubMedCrossRefGoogle Scholar
  17. 17.
    Reubi FC. Glomerular filtration rate, renal blood flow, and blood viscosity during and after diabetic coma. Circ Res 1953; 1: 410–413.PubMedCrossRefGoogle Scholar
  18. 18.
    Zatz R, Meyer TW, Rennke HG, Brenner BM. Predominance of hemodynamic rather than metabolic factors in the pathogenesis of diabetic glomerulopathy. Proc Natl Acad Sci (USA) 1985; 82: 5963–5967.CrossRefGoogle Scholar
  19. 19.
    Zatz R, Dunn BR, Meyer TW, Anderson S, Rennke HG, Brenner BM. Prevention of diabetic glomerulopathy by pharmacological amelioration of glomerular capillary hypertension. J Clin Invest 1986; 77: 1925–1930.PubMedCrossRefGoogle Scholar
  20. 20.
    Seyer-Hansen K. Renal hypertrophy in experimental diabetes mellitus. Kidney Int 1983; 23: 643–646.PubMedCrossRefGoogle Scholar
  21. 21.
    Seyer-Hansen K, Hansen J, Gundersen HJG. Renal hypertrophy in experimental diabetes. A morphometric study. Diabetologia 1980; 18: 501–505.PubMedCrossRefGoogle Scholar
  22. 22.
    Steffes MW, Brown DM, Basgen JM, Mauer SM. Amelioration of mesangial volume and surface alterations following islet transplantation in diabetic rats. Diabetes 1980; 29: 509–515.PubMedGoogle Scholar
  23. 23.
    Mauer SM, Michael AF, Fish AJ, Brown DM. Spontaneous immunoglobulin and complement deposition in glomeruli of diabetic rats. Lab Invest 1972; 27: 488–494.PubMedGoogle Scholar
  24. 24.
    O’Donnell MP, Kasiske BL, Daniels FX, Keane WF. Effect of nephron loss on glomerular hemodynamics and morphology in diabetic rats. Diabetes 1986; 35: 1011–1015.PubMedCrossRefGoogle Scholar
  25. 25.
    Mauer SM, Steffes MW, Azar S, Sandberg SK, Brown DM. The effect of Goldblatt hypertension on development of the glomerular lesions of diabetes mellitus in the rat. Diabetes 1978; 27: 738–744.PubMedCrossRefGoogle Scholar
  26. 26.
    Christiansen JS, Gammelgaard J, Tronier B, Svendsen PA, Parving H-H. Kidney function and size in diabetics before and during initial insulin treatment. Kidney Int 1982; 21: 683–688.PubMedCrossRefGoogle Scholar
  27. 27.
    Parving H-H, Christiansen JS, Noer I, Tronier B, Mogensen CE. The effect of glucagon infusion on kidney function in short-term insulin-dependent juvenile diabetics. Diabetologia 1980; 19: 350–354.PubMedCrossRefGoogle Scholar
  28. 28.
    Christiansen JS, Gammelgaard J, Orskov H, Andersen AR, Telmer S, Parving H-H. Kidney function and size in normal subjects before and during growth hormone administration for one week. Eur J Clin Invest 1980; 11: 487–490.CrossRefGoogle Scholar
  29. 29.
    Vora J, Dolben J, Williams JD, Peters JR, Owens DR. Impact of initial treatment on renal function in newly-diagnosed Type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 1993; 36: 734–740.PubMedCrossRefGoogle Scholar
  30. 30.
    Stackhouse S, Miller PL, Park SK, Meyer TW. Reversal of glomerular hyperfiltration and renal hypertrophy by blood glucose normalization in diabetic rats. Diabetes 1990; 39: 989–995.PubMedCrossRefGoogle Scholar
  31. 31.
    Scholey JW, Meyer TW. Control of glomerular hypertension by insulin administration in diabetic rats. J Clin Invest 1989; 83: 1384–1389.PubMedCrossRefGoogle Scholar
  32. 32.
    Tucker BJ, Anderson CM, Thies RS, Collins RC, Blantz RC. Glomerular hemodynamic alterations during acute hyperinsulinemia in normal and diabetic rats. Kidney Int 1992; 42: 1160–1168.PubMedCrossRefGoogle Scholar
  33. 33.
    Sabbatini M, Sansone G, Uccello F, Giliberti A, Conte G, Andreucci VE. Early glycosylation products induce glomerular hyperfiltration in normal rats. Kidney Int 1992; 42: 875–881.PubMedCrossRefGoogle Scholar
  34. 34.
    Ortola FV, Ballermann BJ, Anderson S, Mendez RE, Brenner BM. Elevated plasma atrial natriuretic peptide levels in diabetic rats. J Clin Invest 1987; 80: 670–674.PubMedCrossRefGoogle Scholar
  35. 35.
    Mattar AL, Ribeiro MO, Fujihara CK, Padilha RM, DeNucci G, Zatz R. Effects of acute and chronic nitric oxide blockade on renal function of diabetic rats. J Am Soc Nephrol 1993; 4: 799 (abstr).Google Scholar
  36. 36.
    Ballermann BJ, Skorecki KL, Brenner BM. Reduced glomerular angiotensin II receptor density in early untreated diabetes mellitus in the rat. Am J Physiol 1984; 247: F110–F116.Google Scholar
  37. 37.
    Wilkes BM, Kaplan R, Mento PF, Aynedjian H Macica CM, Schlondorff D, Bank N. Reduced glomerular thromboxane receptor sites and vasoconstrictor responses in diabetic rats. Kidney Int 1992; 41: 992–999.PubMedCrossRefGoogle Scholar
  38. 38.
    Christlieb AR. Renin, angiotensin and norepinephrine in alloxan diabetes. Diabetes 1974; 23: 962–970.PubMedGoogle Scholar
  39. 39.
    Blantz RC, Peterson OW, Gushwa L, Tucker BJ. Effect of modest hyperglycemia on tubuloglomerular feedback activity. Kidney Int 1982; 22: suppl. 12: S206–S212.Google Scholar
  40. 40.
    Zhang PL, Mackenzie HS, Troy JL, Brenner BM. Effects of an atrial natriuretic peptide receptor antagonist on glomerular hyperfiltration in diabetic rats. J Am Soc Nephrol 1994; in press.Google Scholar
  41. 41.
    Jensen PK, Steven K, Blaehr H, Christiansen JS, Parving H-H. Effects of indomethacin on glomerular hemodynamics in experimental diabetes. Kidney Int 1986; 29: 490–495.PubMedCrossRefGoogle Scholar
  42. 42.
    Mayfield RK, Margolius HS, Levine JH, Wohltmann HJ, Loadholt CB, Colwell JA. Urinary kallikrein excretion in insulin-dependent diabetes mellitus and its relationship to glycemic control. J Clin Endocrinol Metab 1984; 59: 278–286.PubMedCrossRefGoogle Scholar
  43. 43.
    Jaffa AA, Mayfield RK. Kinin: a mediator of diabetes-induced glomerular hyperfiltration. Diabetes 1993; 42: suppl.: 500 (abstr).Google Scholar
  44. 44.
    Goldfarb S, Ziyadeh FN, Kern EFO, Simmons DA. Effects of polyol-pathway inhibition and dietary myo-inositol on glomerular hemodynamic function in experimental diabetes mellitus in rats. Diabetes 1991; 40: 465–471.PubMedCrossRefGoogle Scholar
  45. 45.
    Daniels BS, Hostetter TH. Aldose reductase inhibition and glomerular abnormalities in diabetic rats. Diabetes 1989; 38: 981–986.PubMedCrossRefGoogle Scholar
  46. 46.
    Anderson S, Brenner BM. The critical role of nephron mass and of intraglomerular pressure for initiation and progression of experimental hypertensive-renal disorders. In: Laragh JH, Brenner BM (eds). Hypertension: Pathophysiology, Diagnosis, and Management, 2nd ed. New York: Raven Press; 1994; in press.Google Scholar
  47. 47.
    Kuchan MJ, Frangos JA. Shear stress regulates endothelin-1 release via protein kinase C and cGMP in cultured endothelial cells. Am J Physiol 1993; 264: H150–H156.Google Scholar
  48. 48.
    Buga GM, Gold ME, Fukuto JM, Ignarro LJ. Shear stress-induced release of nitric oxide from endothelial cells grown on beads. Hypertension 1991; 17: 187–193.PubMedCrossRefGoogle Scholar
  49. 49.
    Ott MJ, Ballermann BJ. Shear stress augments glomerular endothelial cell PDGF mRNA expression and mitogen production. J Am Soc Nephrol 1992; 3: 476 (abstr).Google Scholar
  50. 50.
    Riser BL, Cortes P, Zhao X, Bernstein J, Dumler F, Narins RG. Intraglomerular pressure and mesangial stretching stimulate extracellular matrix formation in the rat. J Clin Invest 1992; 90: 1932–1943.PubMedCrossRefGoogle Scholar
  51. 51.
    Riser BL, Cortes P, Zhao X, Sastry KSS, Hassett Cl, Narins RG. Mesangial cell stretch stimulates the formation of transforming growth factor ß and extracellular matrix synthesis. J Am Soc Nephrol 1992; 3: 642 (abstr).Google Scholar
  52. 52.
    Akai Y, Burns KD, Homma T, Harris RC. Mechanical stretch/relaxation stimulates protein kinase C activity, calcium influx and proto-oncogene expression in cultured rat mesangial cells. J Am Soc Nephrol 1992; 3: 460 (abstr).Google Scholar
  53. 53.
    Kaname S, Miyajima Y, Kurokawa K, Ogata E, Uchida S. Hemodynamic shear stress activates latent forms of TGF-ß secreted by rat mesangial cells in culture. J Am Soc Nephrol 1991; 2: 439 (abstr).Google Scholar
  54. 54.
    Anderson S, Rennke HG, Garcia DL, Brenner BM. Short and long term effects of antihypertensive therapy in the diabetic rat. Kidney Int 1989; 36: 526–532.PubMedCrossRefGoogle Scholar
  55. 55.
    Anderson S, Rennke HG, Brenner BM. Nifedipine versus fosinopril in uninephrectomized diabetic rats. Kidney Int 1992; 41: 891–897.PubMedCrossRefGoogle Scholar
  56. 56.
    Cooper ME, Rumble JR, Allen TJ, et al. Antihypertensive therapy and experimental diabetic nephropathy. Kidney Int 1992; 41: 898–903.PubMedCrossRefGoogle Scholar
  57. 57.
    Fujihara C, Padilha RM, Zatz R. Glomerular abnormalities in long-term experimental diabetes. Diabetes 1992; 41: 286–293.PubMedCrossRefGoogle Scholar
  58. 58.
    Geiger H, Bahner U, Vaaben W, et al. Effects of angiotensin-converting enzyme inhibition in diabetic rats with reduced renal function. J Lab Clin Med 1992; 120: 861–867.PubMedGoogle Scholar
  59. 59.
    O’Brien R, Cooper ME, Jerums G, Doyle AE. The effects of perindopril and triple therapy in a normotensive model of diabetic nephropathy. Diabetes 1993; 42: 604–609.PubMedCrossRefGoogle Scholar
  60. 60.
    Brown SA, Walton CL, Crawford P, Bakris GL. Long-term effects of antihypertensive regimens on renal hemodynamics and proteinuria. Kidney Int 1993; 43: 1210–1218.PubMedCrossRefGoogle Scholar
  61. 61.
    Anderson S, Jung FF, Ingelfinger JR. Renal renin-angiotensin system in diabetes: functional, immunohistochemical, and molecular biologic correlations. Am J Physiol 1993; 265: F477–F486.Google Scholar
  62. 62.
    Remuzzi A, Perico N, Amuchastegui CS, Malanchini B, Mazerska M, Battaglia C, Bertani C, Remuzzi G. Short- and long-term effect of angiotensin II receptor blockade in rats with experimental diabetes. J Am Soc Nephrol 1993; 4: 40–49.PubMedGoogle Scholar
  63. 63.
    Kasiske BL, Kalil RSN, Ma JZ, Liao M, Keane WF. Effect of antihypertensive therapy on the kidney in patients with diabetes: a meta-regression analysis. Ann Intern Med 1993; 118: 129–138.PubMedCrossRefGoogle Scholar
  64. 64.
    Weidmann P, Boehlen LM, de Courten M, Ferrari P. Antihypertensive therapy in diabetic patients. J Human Hypertens 1922; 6: suppl. 2: S23-S36.Google Scholar
  65. 65.
    Lewis EJ, Hunsicker LG, Bain RP, Rohde RD. The effect of angiotensin-convertingenzyme inhibition on diabetic nephropathy. N Engl J Med 1993; 329: 1456–1462.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Jiten P. Vora
  • Sharon Anderson
  • Barry M. Brenner

There are no affiliations available

Personalised recommendations