Body Fluids and Blood Pressure in Diabetes, with and without Nephropathy

  • James A. O’Hare
  • J. Barry Ferriss
Part of the Topics in Renal Medicine book series (TIRM, volume 6)


The final determinants of arterial blood pressure are cardiac output and systemic vascular resistance [1]. Cardiac output is determined by extracellular fluid volume and in turn by intravascular volume and filling pressure. Peripheral resistance is influenced by a host of factors, with the renin—angiotensin—aldosterone axis and the sympathetic nervous system each playing an important role.


Diabetic Nephropathy Plasma Renin Activity Urinary Albumin Excretion Sodium Retention Exchangeable Sodium 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Guyton AC: The body’s approach to arterial pressure regulation. In: Circulatory physiology. Ill. Arterial pressure regulation. Philadelphia: WB Saunders. 1980, pp 1–9.Google Scholar
  2. 2.
    Coleman TG, Norman RA, Manning RD: Equilibrium between extracellular and intracellular fluid. In: Circulatory physiology. Il. Dynamics and control of the body fluids. Philadelphia; WB Saunders, 1975, pp 225–242.Google Scholar
  3. 3.
    Guyton AC, Taylor AE, Granger HJ: Capillary exchange and normal fluid convection in the interstitial spaces. In: Circulatory physiology. 11. Dynamics and control of the body fluids. Philadelphia: WB Saunders, 1975, pp 97–124.Google Scholar
  4. 4.
    Ferriss JB, O’Hare JA, Kelleher CCM, Sullivan PA, Cole MM, Ross HF, O’Sullivan DJ: Diabetic control and the renin-angiotensin system, catecholamines, and blood pressure. Hypertension [Suppl 11] 7: 58–63, 1985.Google Scholar
  5. 5.
    Weidmann P, Beretta-Piccoli C, Trost BN: Pressor factors and responsiveness in hypertension accompanying diabetes mellitus. Hypertension [Suppl 11] 7: 33–42, 1985.Google Scholar
  6. 6.
    O’Hare JA, Ferriss JB, Brady D, Twomey B, O’Sullivan DJ: Exchangeable sodium and renin in hypertensive diabetic patients with and without nephropathy. Hypertension [Suppl 11] 7: 43–48, 1985.CrossRefGoogle Scholar
  7. 7.
    Brennan BL, Roginsky MS, Cohn S: Increased total body sodium as a mechanism for suppressed plasma renin activity in diabetes mellitus. Clin Res 27: 591A, 1979.Google Scholar
  8. 8.
    Fauchald P, Norseth J, Jervell J: Transcapillary colloid osmotic gradient, plasma volume and interstitial fluid volume in long-term type 1 (insulin-dependent) diabetes. Diabetologia 28: 269–273, 1985.PubMedCrossRefGoogle Scholar
  9. 9.
    Brochner-Mortensen J, Ditzel J: Glomerular filtration rate and extracellular fluid volume in insulin-dependent patients with diabetes mellitus. Kidney Int 21: 696–698, 1982.PubMedCrossRefGoogle Scholar
  10. 10.
    Fisher BM, Gillen G, Ong-Tone L, Dargie HJ, Frier BM: Cardiac function and insulin-dependent diabetes: radionuclide ventriculography in young diabetics. Diabetic Med 2: 25 1256, 1985.Google Scholar
  11. 11.
    Drury PL, Smith GM, Ferriss JB: Increased vasopressor responsiveness to angiotensin II in type I (insulin-dependent) diabetic patients without complications. Diabetologia 27: 174–179, 1984.PubMedGoogle Scholar
  12. 12.
    O’Hare JA, Ferriss JB, Twomey B, O’Sullivan DJ: Poor metabolic control, hypertension and microangiopathy independently increase the transcapillary escape rate of albumin in diabetes. Diabetologia 25: 260–263, 1983.PubMedCrossRefGoogle Scholar
  13. 13.
    Feldt-Rasmussen B: Increased transcapillary escape rate of albumin in type I (insulindependent) diabetic patients with microalbuminuria. Diabetologia 29: 282–286, 1986.PubMedCrossRefGoogle Scholar
  14. 14.
    O’Hare JA, Ferriss JB: Transcapillary escape rate of albumin and extracellular fluid volume in diabetes. Diabetologia 28: 937–938, 1985.PubMedCrossRefGoogle Scholar
  15. 15.
    Roland JM, O’Hare JP, Walters G, Corrall RJM: Sodium retention in response to saline infusion in uncomplicated diabetes mellitus. Diabetic Res 3: 213–215, 1986.Google Scholar
  16. 16.
    O’Hare JP, Roland JM, Walters G, Corrall RJM: Impaired sodium excretion in response to volume expansion induced by water immersion in insulin-dependent diabetes mellitus. Clin Sci 71: 403–409, 1986.PubMedGoogle Scholar
  17. 17.
    DeFronzo RA: The effect of insulin on renal sodium metabolism. Diabetologia 21: 165–171, 1981.PubMedCrossRefGoogle Scholar
  18. 18.
    O’Hare JA, Ferriss JB, Twomey BM, Cole M, Brady D, O’Sullivan DJ: Blood pressure may be sodium dependent in diabetic patients without overt nephropathy. Ir J Med Sci 154: 455460, 1985.Google Scholar
  19. 19.
    Coleman TG, Guyton AC: Hypertension caused by salt loading in the dog. Cir Res 25: 153–160, 1969.CrossRefGoogle Scholar
  20. 20.
    Christlieb AR, Kaldany A, D’Elia JA: Plasma renin activity and hypertension in diabetes mellitus. Diabetes 25: 969–974, 1976.PubMedCrossRefGoogle Scholar
  21. 21.
    Moss S, Oster JR, Perez GO, Katz FH, Vaamonde CA: Renin—aldosterone responsiveness in uncomplicated juvenile-type diabetes mellitus. Horm Res 9: 130–136, 1978.PubMedCrossRefGoogle Scholar
  22. 22.
    Drury PL, Bodansky HJ, Oddie CJ, Edwards CRW: Factors in the control of plasma renin activity and concentration in type I (insulin-dependent) diabetes. Clin Endocrinol 20: 607618, 1984.Google Scholar
  23. 23.
    O’Hare JA, Ferriss JB, Twomey BM, Brady D, O’Sullivan DJ: Essential hypertension and hypertension in diabetic patients without nephropathy. J Hypertension [Suppl 2] 1: 200–203, 1983.Google Scholar
  24. 24.
    Fuller JH: Epidemiology of hypertension associated with diabetes mellitus. Hypertension [Suppl 11] 7: 3–7, 1985.CrossRefGoogle Scholar
  25. 25.
    United Kingdom Prospective Diabetes Study: Prevalence of hypertension and hypotensive therapy in patients with newly diagnosed diabetes. Hypertension [Suppl 11] 7: 8–13, 1985.CrossRefGoogle Scholar
  26. 26.
    Beretta-Piccoli C, Davies DL, Boddy K, Brown JJ, Cumming AMM, East BW, Fraser R, Lever AF, Padfield PL, Semple PF, Robertson JIS, Wiedmann P, Williams ED: Relation of arterial pressure with body sodium, body potassium and plasma potassium in essential hypertension. Clin Sci 63: 257–270, 1982.PubMedGoogle Scholar
  27. 27.
    Ferriss JB, O’Hare JA, Cole M, Kingston SM, Twomey BM, O’Sullivan DJ: Blood pressure in diabetic patients: relationships with exchangeable sodium and renin activity. Diabetic Nephropathy 5: 27–30, 1986.Google Scholar
  28. 28.
    Watkins PJ, Edmonds ME: Sympathetic nerve failure in diabetes. Diabetologia 25: 73–77, 1983.PubMedCrossRefGoogle Scholar
  29. 29.
    D’Elia JA, Weinrauch LA, Healy RW, Libertino JA, Bradley RF, Leland OS: Myocardial dysfunction without coronary artery disease in diabetic renal failure. Am J Cardiol 43: 193199, 1979.Google Scholar
  30. 30.
    Beretta-Piccoli C, Weidmann P, De Chatel R, Reubi F: Hypertension associated with early stage kidney disease. Am J Med 61: 739–747, 1976.PubMedCrossRefGoogle Scholar
  31. 31.
    Christlieb AR, Kaldany A, D’Elia JA, Williams GH: Aldosterone responsiveness in patients with diabetes mellitus. Diabetes 27: 732–737, 1978.PubMedCrossRefGoogle Scholar
  32. 32.
    Tuck ML, Sambhi MP, Levin L: Hyporeninemic hypoaldosteronism in diabetes mellitus. Diabetes 28: 237–241, 1979.PubMedGoogle Scholar
  33. 33.
    Ferriss JB, Sullivan PA, Gonggrijp H, Cole M, O’Sullivan DJ: Plasma angiotensin II and aldosterone in unselected diabetic patients. Clin Endocrinol 17: 261–269, 1982.CrossRefGoogle Scholar
  34. 34.
    Bjorck S, Delin K, Herlitz H, Larsson O, Aurell M: Renin secretion in advanced diabetic nephropathy. Scand J Urol Nephrol [Suppl] 79: 53–57, 1984Google Scholar
  35. 35.
    Luetscher JA, Kraemer FB, Wilson DM, Schwartz HC, Bryer-Ash M: Increased plasma inactive renin in diabetes mellitus: a marker of microvascular complications. N Engl J Med 312: 1412–1417, 1985.PubMedCrossRefGoogle Scholar
  36. 36.
    Dathan JRE, Johnson DB, Goodwin FJ: The relationship between body fluid compartment volumes, renin activity and blood pressure in chronic renal failure. Clin Sci Mol Med 45: 7788, 1973.Google Scholar
  37. 37.
    Weidmann P, Beretta-Piccoli C, Steffen F, Blumberg A, Reubi FC: Hypertension in terminal renal failure. Kidney Int 9: 294–301, 1976.PubMedCrossRefGoogle Scholar
  38. 38.
    Goldstein DA, Massry SG: Diabetic nephropathy: clinical course and effect of hemodialysis. Nephron 20: 286–296, 1978.PubMedCrossRefGoogle Scholar
  39. 39.
    O’Hare JA, Ferriss JB, Twomey B, Brady D, O’Sullivan DJ: Diabetic orthostatic hypotension: the role of total exchangeable sodium and nephropathy. Diabetes Res 3: 301–306, 1986.PubMedGoogle Scholar
  40. 40.
    Mogensen CE: Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy. Br Med J 285: 685–688, 1982.CrossRefGoogle Scholar
  41. 41.
    Parving H-H, Andersen AR, Smidt UM, Svendsen PA: Early aggressive antihypertensive treatment reduces rate of decline in kidney function in diabetic nephropathy. Lancet 1: 1175 1179, 1983.Google Scholar
  42. 42.
    Weidmann P, Beretta-Piccoli C, Keusch G, Gluck Z, Mujagic M, Grimm M, Meier A, Ziegler WH: Sodium-volume factor, cardiovascular reactivity and hypotensive mechanism of diuretic therapy in mild hypertension associated with diabetes mellitus. Am J Med 67: 779–784, 1979.PubMedCrossRefGoogle Scholar
  43. 43.
    Hommel E, Parving H-H, Mathiesen E, Edsberg B, Nielsen MD, Giese J: Effect of captopril on kidney function in insulin-dependent diabetic patients with nephropathy. Br Med J 293: 467–470, 1986.CrossRefGoogle Scholar
  44. 44.
    Taguma Y, Kitamoto Y, Futaki G, Weda H, Monma H, Ishizaki M, Takahashi H, Sekino H, Sasaki Y: Effect of captopril on heavy proteinuria in azotemic diabetics. N Engl J Med 313: 1617–1620, 1985.PubMedCrossRefGoogle Scholar
  45. 45.
    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 77: 1925–1930, 1986.PubMedCrossRefGoogle Scholar
  46. 46.
    Parving H-H, Kastrup H, Smidt UM, Andersen AR, Feldt-Rasmussen B, Christiansen JS: Impaired autoregulation of glomerular filtration rate in type I (insulin dependent) diabetic patients with nephropathy. Diabetologia 27: 547–552, 1984.PubMedCrossRefGoogle Scholar
  47. 47.
    Bjorck S, Nyberg G, Mulec H, Granerus G, Herlitz H, Aurell M: Beneficial effects of angiotensin converting enzyme inhibition on renal function in patients with diabetic nephropathy. Br Med J 293: 471–474, 1986.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1988

Authors and Affiliations

  • James A. O’Hare
  • J. Barry Ferriss

There are no affiliations available

Personalised recommendations