期刊
JOURNAL OF DIABETES AND ITS COMPLICATIONS
卷 36, 期 3, 页码 -出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jdiacomp.2022.108127
关键词
Diabetes mellitus type 2; Diabetic kidney disease; Kidney hemodynamics; Glomerular hyperfiltration; Arterial stiffness; Endothelial dysfunction
资金
- European commission [282521]
- Boehringer Ingelheim
- AstraZenenca
This study found that systemic vascular pathology is related to diabetic kidney disease, with endothelial dysfunction and arterial stiffness being associated with glomerular hyperfiltration.
Aims: Glomerular hyperfiltration plays a key role in the pathophysiology of diabetic kidney disease (DKD). Mechanisms underlying this adverse hemodynamic profile are incompletely understood. We hypothesized that systemic vascular pathology, including endothelial dysfunction and arterial stiffness, relates to glomerular hyperfiltration indicated by filtration fraction (FF). Methods: Baseline data of three trials of overweight adults with type 2 diabetes (TD2, n = 111) with relatively well preserved kidney function were analyzed. Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and FF, were assessed with gold-standard clearance techniques. Systemic vascular resistance (SVR), an indicator of endothelial dysfunction, and pulse pressure (PP), a measure of arterial stiffness, were derived from continuous beat-to-beat monitoring. Results: SVR related negatively to GFR (13: -0.382, p < 0.001) and ERPF (13: -0.475, p < 0.001), and positively to FF (13:0.369, p < 0.001). Associations between SVR, ERPF and FF persisted after multivariable adjustments.. PP was negatively related to ERPF (13: -0.252, p = 0.008), and positively to FF (13: 0.257, p = 0.006), of which the latter remained significant in multivariable regression. Conclusion: Parameters of systemic vascular pathology, including endothelial dysfunction and arterial stiffness, relate to an adverse kidney hemodynamic profile characterized by glomerular hyperfiltration, which predisposes to the development of DKD.
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