Definition of Diabetic Renal Disease in Insulin-Dependent Diabetes Mellitus Based on Renal Function Tests

  • Carl Erik Mogensen
Chapter

Abstract

Defining renal disease and renal involvement in diabetes appeared not to be an easy task, mainly because of the wide range of changes seen. The different degree of abnormalities, often with the same duration of disease, seemingly same quality of long-term metabolic control, and the same type of diabetes, may according to older literature indeed be striking [1–2]. However, with better techniques and more well-defined patients [3] much more consistency is found, although the situation in very long-term diabetes with normoalbuminuria still needs further clarification [4].

Keywords

Diabetic Nephropathy Renal Involvement Proliferative Diabetic Retinopathy Urinary Albumin Excretion Albumin Excretion Rate 
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.
    Thomsen OF, Andersen AR, Christiansen JS, Deckert T. Renal changes in long-term type 1 (insulin-dependent) diabetic patients with and without clinical nephropathy: a light microscopic, morphometric study of autopsy material. Diabetologia 1984; 26:361–365.PubMedCrossRefGoogle Scholar
  2. 2.
    Mauer SM, Steffes MW, Ellis EN, Sutherland DER, Brown DM, Goetz FC. Structural-functional relationships in diabetic nephropathy. J Clin Invest 1984; 74:1143–1155.PubMedCrossRefGoogle Scholar
  3. 3.
    Hansen KW, Mau Pedersen M, Christensen CK, Schmitz A, Christiansen JS, Mogensen CE. Normoalbuminuria ensures no reduction of renal function in type 1 (insulin-dependent) diabetic patients. J Intern Med 1992; 232:161–167.PubMedCrossRefGoogle Scholar
  4. 4.
    Poulsen PL, Ebbehøj E, Mogensen CE. Elevated blood pressure in microalbuminuric IDDM patients is associated with low renal plasma flow (Abstract). Diabetologia 1996; 39: Suppl. 1: A301.Google Scholar
  5. 5.
    Mogensen CE, Christensen CK, Vittinghus E. The stages in diabetic renal disease. With emphasis on the stage of incipient diabetic nephropathy. Diabetes 1983; 32: Suppl. 2: 64–78.PubMedGoogle Scholar
  6. 6.
    Bangstad H-J, Osterby R, Dahl-Jørgensen K, Berg KJ, Hartmann A, Hanssen KF. Improvement of blood glucose control retards the progression of morphological changes in early diabetic nephropathy. Diabetologia 1994; 37: 483–490.PubMedCrossRefGoogle Scholar
  7. 7.
    Østerby R. Microalbuminuria in diabetes mellitus: Is there a structural basis? (editorial). Nephrol Dial Transpl 1995; 10:12–14.Google Scholar
  8. 8.
    Viberti GC, Jarrett RJ, Mahmud U, Hill RD, Argyropoulos A, Keen H. Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet 1982; i: 1430–1432.CrossRefGoogle Scholar
  9. 9.
    Parving H-H, Oxenbøll B, Svendsen PAA, Christiansen JS, Andersen AR. Early detection of patients at risk of developing diabetic nephropathy: a longitudinal study of urinary albumin excretion. Acta Endocrinol (Copenh) 1982; 100: 550–555.Google Scholar
  10. 10.
    Mogensen CE, Christensen CK. Predicting diabetic nephropathy in insulin-dependent patients. N Engl J Med 1984; 311: 89–93.PubMedCrossRefGoogle Scholar
  11. 11.
    Mathiesen ER, Oxenbøll B, Johansen K, Svendsen PA, Deckert T. Incipient nephropathy in type I (insulin-dependent) diabetes. Diabetologia 1984; 26: 406–410.PubMedCrossRefGoogle Scholar
  12. 12.
    Poulsen PL, Hansen KW, Mogensen CE. Ambulatory blood pressure in the transition from normo- to microalbuminuria. A longitudinal study in IDDM patients. Diabetes 1994; 43: 1248–1253.PubMedCrossRefGoogle Scholar
  13. 13.
    Christensen CK, Mogensen CE. The course of incipient diabetic nephropathy: Studies of albumin excretion and blood pressure. Diabetic Med 1985; 2:97–102.PubMedCrossRefGoogle Scholar
  14. 14.
    Feldt-Rasmussen B, Mathiesen E, Deckert T. Effect of two years of strict metabolic control on the progression of incipient nephropathy in insulin-dependent diabetes. Lancet 1986; ii: 1300–1304.CrossRefGoogle Scholar
  15. 15.
    The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New Engl J Med 1993; 329:977–986.CrossRefGoogle Scholar
  16. 16.
    Mogensen CE. »Microalbuminuria and kidney function in diabetes: Notes on methods, interpretation and classification.« In Methods in Diabetes Research, volume II: Clinical Methods, W.L. Clarke, J. Lamer, S.L. Pohl, eds. New York, Chichester, Brisbane, Toronto, Singapore: John Wiley & Sons, 1986; pp 611–631.Google Scholar
  17. 17.
    Vestbo E, Damsgaard EM, Frøland A, Mogensen CE. Urinary albumin excretion in a population based cohort. Diabetic Med 1995; 12:488–493.PubMedCrossRefGoogle Scholar
  18. 18.
    Mogensen CE. Urinary albumin excretion in early and long-term juvenile diabetes. Scand J Clin Lab Invest 1971; 28:183–193.PubMedCrossRefGoogle Scholar
  19. 19.
    Christensen CK, Mogensen CE. Acute and long-term effect of antihypertensive treatment on exercise-induced albuminuria in incipient diabetic nephropathy. Scand J Clin Lab Invest 1986; 46: 553–559.PubMedCrossRefGoogle Scholar
  20. 20.
    Viberti GC, Mogensen CE, Keen H, Jacobsen FK, Jarrett RJ, Christensen CK. Urinary excretion of albumin in normal man. The effect of water loading. Scand J Clin Lab Invest 1982; 42: 147–152.PubMedCrossRefGoogle Scholar
  21. 21.
    Mogensen CE, Chachati A, Christensen CK, Close CF, Deckert T, Hommel E, Kastrup J, Lefebvre P, Mathiesen ER, Feldt-Rasmussen B, Schmitz A, Viberti GC. Microalbuminuria: an early marker of renal involvement in diabetes. Uremia Invest 1985–86; 9: 85–95.Google Scholar
  22. 22.
    Messent JWC, Elliott TG, Hill RD, Jarrett RJ, Keen H, Viberti GC. Prognostic significance of microalbuminuria in insulin-dependent diabetes mellitus: A twenty-three year follow-up study. Kidney Int 1992; 41: 836–839.PubMedCrossRefGoogle Scholar
  23. 23.
    Mogensen CE, Vestbo E, Poulsen PL, Christiansen C, Damsgaard EM, Eiskjær H, Frøland A, Hansen KW, Nielsen S, Mau Pedersen M. Microalbuminuria and potential confounders. A review and some observations on variability of urinary albumin excretion. Diabetes Care 1995; 18: 572–581.PubMedGoogle Scholar
  24. 24.
    Rossing P, Hommel E, Smidt UM, Parving H-H. Impact of arterial blood pressure and albuminuria on the progression of diabetic nephropathy in IDDM Patients. Diabetes 1993; 42: 715–719.PubMedCrossRefGoogle Scholar
  25. 25.
    Rossing P, Hommel E, Smidt UM, Parving H-H. Reduction in albuminuria predicts a beneficial effect on diminishing the progression of human diabetic nephropathy during antihypertensive treatment Diabetologia 1994; 37: 511–516.PubMedCrossRefGoogle Scholar
  26. 26.
    Rossing P, Hommel E, Smidt UM, Parving H-H. Reduction in albuminuria predicts diminished progression in diabetic nephropathy. Kidney Int 1994; Suppl. 45: S145–149.Google Scholar
  27. 27.
    Parving H-H, Rossing P, Hommel E, Smidt UM. Angiotensin-Converting enzyme-inhibition in diabetic nephropathy -10 years experience. Am J Kidney Dis 1995; 26:99–107.PubMedCrossRefGoogle Scholar
  28. 28.
    Bojestig M, Arnqvist HJ, Hermansson G, Karlberg BE, Ludvigsson J. Declining incidence of nephropathy in insulin-dependent diabetes mellitus. N Engl J Med 1994; 330:15–18.PubMedCrossRefGoogle Scholar
  29. 29.
    Deckert T, Kofoed-Enevoldsen A, Vidal P, Nørgaard K, Andreasen HB, Feldt-Rasmussen B. Size- and charge selectivity of glomerular filtration in IDDM patients with and without albuminuria. Diabetologia 1993; 36: 244–251.PubMedCrossRefGoogle Scholar
  30. 30.
    Remuzzi G, Ruggenenti P, Mauer SM. Pancreas and kidney/pancreas transplants: experimental medicine or real improvement? Lancet 1994; 343:27–31.PubMedCrossRefGoogle Scholar
  31. 31.
    Mogensen CE, Christensen CK. Blood pressure changes and renal function changes in incipient and overt diabetic nephropathy. Hypertension 1985; 7: II-64-II-73.CrossRefGoogle Scholar
  32. 32.
    Mogensen CE. Diabetic Renal Disease: The quest for normotension — and beyond. Diabetic Med 1995; 12: 756–769.PubMedCrossRefGoogle Scholar
  33. 33.
    Molitch ME, Steffes MW, Cleary PA, Nathan DM. Baseline analysis of renal function in the diabetes control and complications trial. Kidney Int 1993; 43:668–674.PubMedCrossRefGoogle Scholar
  34. 34.
    Strojek K, Grzeszczak W, Lacka B, Gorska J, Keller CK, Ritz E. Increased prevalence of salt sensitivity of blood pressure in IDDM with and without microalbuminuria. Diabetologia 1995; 38: 1443–1448.PubMedCrossRefGoogle Scholar
  35. 35.
    Gerdts E, Svarstad E, Myking OL. Lund-Johansen P, Omvik P. Salt sensitivity in hypertensive type-1 diabetes mellitus. Blood Pressure 1996; 5: 78–85.PubMedCrossRefGoogle Scholar
  36. 36.
    Vigstrup J, Mogensen CE. Proliferative diabetic retinopathy: at risk patients identified by early detection of microalbuminuria. Acta Ophthalmol 1985; 63:530–534.Google Scholar
  37. 37.
    Feldt-Rasmussen B. Increased transcapillary escape rate of albumin in type 1 (insulin-dependent) diabetic patients with microalbuminuria. Diabetologia 1986; 29: 282–286.PubMedCrossRefGoogle Scholar
  38. 38.
    Deckert T, Yokoyama H, Mathiesen E, Rann B, Jensen T, Feldt-Rasmussen B, Borch-Johnsen K, Jensen JS. Cohort study of predictive value of urinary albumin excretion for atherosclerotic vascular disease in patients with insulin dependent diabetes. BMJ 1996; 312: 871–874.PubMedCrossRefGoogle Scholar
  39. 39.
    Mogensen CE, Christensen CK, Christensen PD, Hansen KW, Mølgaard H, Mau Pedersen M, Poulsen PL, Schmitz A, Thuesen L, Østerby R. »The abnormal albuminuria syndrome in diabetes.« In Current Topics in Diabetes Research. Front Diabetes, F. Belfiore, R.N. Bergman, G.M. Molinatti, eds. Basel: Karger, 1993; pp 86–121.Google Scholar
  40. 40.
    Franken AAM, Derkx FHM, Manint Veld AJ, et al. High plasma prorenin in diabetes mellitus and its correlation with some complications. J Clin Endocrinol Metab 1990; 71:1008–1015.PubMedCrossRefGoogle Scholar
  41. 41.
    Matinlauri IH, Rönnemaa T, Koskinen PJ, Aalto MA, Viikari JSA, Irjala KMA. Elevated serum total renin is insensitive in detecting incipient diabetic nephropathy. Diabetes Care 1995; 18: 1357–1361.PubMedCrossRefGoogle Scholar
  42. 42.
    Mathiesen ER, Rønn B, Storm B, Foght H, Deckert T. The natural course of microalbuminuria in insulin-dependent diabetes: a 10-year prospective study. Diabetic Med 1995; 12:482–487.PubMedCrossRefGoogle Scholar
  43. 43.
    Krolewski AS, Laffel LMB, Krolewski M, Quinn M, Warram JH. Glycosylated hemoglobin and the risk of microalbuminuria in patients with insulin-dependent diabetes mellitus. N Engl J Med 1995;332:1251–1255.PubMedCrossRefGoogle Scholar
  44. 44.
    Rossing P, Rossing K, Jacobsen P, Parving H-H. Unchanged incidence of diabetic nephropathy in IDDM patients. Diabetes 1995; 44: 739–743.PubMedCrossRefGoogle Scholar
  45. 45.
    Christensen CK, Krusell LR, Mogensen CE. Increased blood pressure in diabetes: essential hypertension or diabetic nephropathy? Scand J Clin Lab Invest 1987; 47: 363–370.PubMedCrossRefGoogle Scholar
  46. 46.
    Microalbuminuria Collaborative Study Group UK. Risk factors for development of microalbuminuria in insulin dependent diabetic patients: a cohort study. BMJ 1993; 306: 1235–1239.CrossRefGoogle Scholar
  47. 47.
    Mogensen CE. Angiotensin converting enzyme inhibitors and diabetic nephropathy (editorial). BMJ 1992; 304: 227–228.CrossRefGoogle Scholar
  48. 48.
    Mogensen CE. Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy. BMJ 1982; 285:685–688.PubMedCrossRefGoogle Scholar
  49. 49.
    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
  50. 50.
    Brøchner-Mortensen J. Current status on assessment and measurement of glomerular filtration rate. Clin Physiol 1985; 5: 1–17.PubMedCrossRefGoogle Scholar
  51. 51.
    Jones SL, Viberti GC. »Methodologies to assess renal function in diabetes mellitus.« In Research Methodologies in Human Diabetes. Diabetes Forum Series, Volume V, CE. Mogensen, E. Standi, eds. Berlin: Walter de Gruyter, 1994; pp 359–385.Google Scholar
  52. 52.
    Mogensen CE, Hansen KW, Sommer, S, Klebe J, Christensen CK, Marshall S, Schmitz A, Mau Pedersen M, Christiansen JS, Pedersen EB. »Microalbuminuria: Studies in diabetes, essential hypertension, and renal diseases as compared with the background population.« In Advances in Nephrology, Vol. 20, J.P. Grünfeld, J.F. Bach, J.-L. Funck-Brentano, M.H. Maxwell, eds. St. Louis, Baltimore, Boston, Chicago, London, Philadelphia, Sydney, Toronto: Mosby Year Book, 1991; pp 191–228.Google Scholar
  53. 53.
    Mogensen CE. Management of renal disease and hypertension in insulin-dependent diabetes, with an emphasis on early nephropathy. Curr Opin Nephrol Hypertens 1992; 1:106–115.PubMedCrossRefGoogle Scholar
  54. 54.
    Mauer SM, Mogensen CE, Viberti GC. Introduction. Symposium on the Progression Diabetic Nephropathy. Kidney Int 1992; 41:717–718.CrossRefGoogle Scholar
  55. 55.
    Mogensen CE, Hansen KW, Østerby R, Damsgaard EM Blood pressure elevation versus abnormal albuminuria in the genesis and prediction of renal disease in diabetes. Diabetes Care 1992; 15:1192–1204PubMedCrossRefGoogle Scholar
  56. 56.
    Mogensen CE, Damsgaard EM, Frøland A, Hansen KW, Nielsen S, Mau Pedersen M, Schmitz A, Thuesen L, Osterby R. Reduced glomerular filtration rate and cardiovascular damage in diabetes: a key role for abnormal albuminuria. Acta Diabetol 1992; 29: 201–213.CrossRefGoogle Scholar
  57. 57.
    Mogensen CE, Poulsen PL, Heinsvig EM. «Abnormal albuminuria in the monitoring of early renal changes in diabetes.» In Concepts for the Ideal Diabetes Clinic. Diabetes Forum Series, Volume 4, C.E. Mogensen, E. Standi, eds. Berlin, New York: Walter de Gruyter, 1993; pp 289–313.Google Scholar
  58. 58.
    Mogensen CE, Hansen KW, Nielsen S, Mau Pedersen M, Rehling M, Schmitz A. Monitoring diabetic nephropathy: Glomerular filtration rate and abnormal albuminuria in diabetic renal disease — reproducibility, progression, and efficacy of antihypertensive intervention. Am J Kidney Dis 1993; 22: 174–187.PubMedGoogle Scholar
  59. 59.
    Mogensen CE, Berne C, Ritz E, Viberti G-C. Preface. The kidney in Type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 1993; 36:977.CrossRefGoogle Scholar
  60. 60.
    Mogensen CE. Microalbuminuria, early blood pressure elevation and diabetic renal disease. Curr Opin Endocrinol 1994; 4: 239–247.CrossRefGoogle Scholar
  61. 61.
    Mogensen CE. Systemic blood pressure and glomerular leakage with particular reference to diabetes and hypertension. J Intern Med 1994; 235:297–316.PubMedCrossRefGoogle Scholar
  62. 62.
    Mogensen CE. Microalbuminuria in prediction and prevention of diabetic nephropathy in insulin-dependent diabetes mellitus patiens. J Diabetes and Its Complications 1995; 9: 337–349.CrossRefGoogle Scholar
  63. 63.
    Alzaid AA. Microalbuminuria in patients with NIDDM: An overview. Diabetes Care 1996; 19: 79–89.PubMedCrossRefGoogle Scholar
  64. 64.
    Gilbert RE, Cooper ME, McNally PG, O’Brien RC, Taft J, Jerums G. Microalbuminuria: Prognostic and therapeutic implications in diabetes mellitus. Diabetic Med 1994; 11: 636–645.PubMedCrossRefGoogle Scholar
  65. 65.
    DeFronzo RA Diabetic nephropathy: etiologic and therapeutic considerations. Diabetes Rev 1995;3:510–564.Google Scholar
  66. 66.
    Breyer JA Medical management of nephropathy in type I diabetes mellitus: Current recommendations. J Am Soc Nephrol 1995; 6:1523–1529.PubMedGoogle Scholar
  67. 67.
    Gosling P. Microalbuminuria: a marker of systemic disease. Br J Hosp Med 1995; 54:285–290.PubMedGoogle Scholar
  68. 68.
    Raskin GS, Tamborlane WV. Molecular and physiological aspects of nephropathy in type I (insulin-dependent) diabetes mellitus. J Diabetes and Its Complications 1996; 10:31–37.CrossRefGoogle Scholar
  69. 69.
    Clark CM, Lee DA. Prevention and treatment of the complications of diabetes mellitus. N Engl J Med 1995; 332: 1210–1217.PubMedCrossRefGoogle Scholar
  70. 70.
    Mogensen CE. »Management of the diabetic patient with elevated blood pressure or renal disease. Early screening and treatment programs: albuminuria and blood pressure.« In Hypertension: Pathology, Diagnosis & Management. 2nd ed, J.H. Laragh, B.M. Brenner, eds. New York: Raven Press Ltd., 1995; pp 2335–2365.Google Scholar
  71. 71.
    Leese GP, Vora JP. The management of hypertension in diabetes: with special reference to diabetic kidney disease. Diabetic Med 1996; 13: 401–410.PubMedCrossRefGoogle Scholar
  72. 72.
    Ishii H, Jirousek MR, Koya D, Takagi C, Xia P, Clermont A, Bursell S-E, Kern TS, Ballas LM, Heath WF, Stramm LE, Feener EP, King GL. Amelioration of vascular dysfunctions in diabetic rats by an oral PKC β inhibitor. Science 1996; 272: 728–731.PubMedCrossRefGoogle Scholar
  73. 73.
    Drickamer K. Breakingthe curse of the AGEs. Nature 1996; 382: 211–212.PubMedCrossRefGoogle Scholar
  74. 74.
    Vasan S, Zhang X, Zhang X, Kapumiotu A, Bernhagen J, Teichberg S, Basgen J, Wagle D, Shih D, Terlecky I, Bucala R, Cerami A, Egan J, Ulrich P. An agent cleaving glucose-derived protein crosslinks in vitro and in vivo. Nature 1996; 382: 275–278.PubMedCrossRefGoogle Scholar
  75. 75.
    Li YM, Steflfes M, Donnelly T, Liu C, Fuh H, Basgen J, Bucala R, Vlassara H. Prevention of cardiovascular and renal pathology of aging by the advanced glycation inhibitor aminoguanidine. Proc Natl Acad Sci USA 1996; 93: 3902–3907.PubMedCrossRefGoogle Scholar
  76. 76.
    Friedman EA. Will pimagidine improve survival of diabetics on dialysis? Nephrol Dial Transplant 1996; 11: 1524–1527.PubMedCrossRefGoogle Scholar
  77. 77.
    The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997; 20:1183–1197.Google Scholar
  78. 78.
    The sixth report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Arch Intern Med 1997; 157: 2413–2446.CrossRefGoogle Scholar
  79. 79.
    Fagan TC. Evolution of the Joint National Committee Reports, 1988–1997. Evolution of the Science of Treating Hypertension. Arch Intern Med 1997; 157:2401–2402PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1998

Authors and Affiliations

  • Carl Erik Mogensen
    • 1
  1. 1.Medical Department MAarhus KommunehospitalAarhusDenmark

Personalised recommendations