scholarly journals Atherosclerotic stenos of renal arteries at patients with diabetes mellitus and arterial hypertension.

2009 ◽  
Vol 6 (3) ◽  
pp. 28-32
Author(s):  
Viktor Viktorovich Fomin ◽  
Sergey Valentinovich Moiseev ◽  
Mikhail Yur'evich Shvetsov ◽  
Nikolay Alekseevich Mukhin
Keyword(s):  
Diabetes Mellitus ◽  
Renal Disease ◽  
Arterial Hypertension ◽  
Renal Arteries ◽  
Atherosclerotic Stenosis ◽  
Patients With Diabetes ◽  
Ischemic Renal Disease

Problems of diagnostics and treatment of ischemic renal disease (atherosclerotic stenosis of renal arteries) at patients with diabetes mellitus are discussed.

scholarly journals ASSESSMENT OF NEPHRIN AND PODOCIN LEVELS IN THE URINE OF PATIENTS WITH DIABETES MELLITUS

2017 ◽  
Vol 21 (2) ◽  
pp. 33-40
Author(s):  
I. N. Bobkova ◽  
A. A. Shchukina ◽  
M. V. Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Arterial Hypertension ◽  
Healthy Subjects ◽  
Early Diagnostics ◽  
Urinary Levels ◽  
Patients With Diabetes ◽  
Early Diabetic Nephropathy

THE AIM:to assess excretion value of podocytes injury biomarkers in urine and to clarify their significance for early diabetic nephropathy (DN) diagnostics in diabetes mellitus (DM) patients with different severity of albuminuria (AU)/proteinuria(PU).PATIENTS AND METHODS.74 DM pts were studied, including 30 with type1 DM (T1DM) and 44 pts with type2 DM (T2DM). They were divided into three groups: 41 pts with AU <30 mg/gCr (A1), 13 pts with AU 30-300 mg/gCr (A2), 20 pts with PU (A3). CKD S1 was revealed in 41pts, CKD S2 – in 25 pts, CKD S3 – in 8 pts. Arterial hypertension was observed in 52 pts of 74(70%), mainly in T2DM. 10 healthy subjects were studied as control. Urinary levels of nephrin and podocin (an important slit diaphragm proteins) were measured by ELISA.RESULTS.Nephrinuria (NU) >5,84ng/ml/g, which not detecting in controls, was revealed in 63% of A1 pts, in 77% – in A2, in 80% – in A3. Podocinuria (PdU)>1,73ng/ml/g was revealed in 78% of A1 pts, in 54% of A2 and in 83% – A3. NU in pts with PU was significantly higher than in AU<30 mg/g. PDU in groups with different AU/PU was equally high and has no differ between DM types. Direct correlation was obtained between NU and AU (R=0,947 p<0,05). NU and PdU in T1DM correlated directly with serum creatinine (R=0,489 p<0,05 and R=0,468 p<0,05) and indirectly with GFR (R=-0,461 p<0,05 and R=-0,36 р<0,05). In DM duration less than 5 years NU directly correlated with НbА1с level, in T2DM – indirectly with systolic blood pressure.CONCLUSON. Nephrin and podocin levels can be useful for early diagnostics and monitoring of DN. 

scholarly journals Factors promoting development of renal tubulointerstitial lesions in patients with diabetes mellitus

2010 ◽  
Vol 13 (3) ◽  
pp. 134-141 ◽  
Author(s):  
Minara Shamkhalovna Shamkhalova ◽  
Kseniya Olegovna Kurumova ◽  
Inna Igorevna Klefortova ◽  
Ivan Ivanovich Sitkin ◽  
Alexander Viktorovich Il'in ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Growth Factor ◽  
Endothelial Dysfunction ◽  
Abdominal Aorta ◽  
Transforming Growth Factor ◽  
Renal Arteries ◽  
Renal Pathology ◽  
Enhanced Production ◽  
Tubulointerstitial Lesions ◽  
Patients With Diabetes

Aim. To identify profibrogenic mediators, markers of endothelial dysfunction and hemostasis in patients with diabetes mellitus (DM) and chronickidney disease (CKD). Materials and methods. The study included 120 patients with DM and 20 age-matched normotensive subjects without DM showing the glomerularfiltration rate (GFR) > 60 ml/min/1.73 m3. Four groups of patients were distinguished: 1 - DM2 patients without renal pathology (n=33), 2 - DM2 patients with diabetic nephropathy (n=24), 3 - DM2 patients with ischemic nephropathy (IN) (n=33) verified by contrast visualization techniques(multispiral CM of abdominal aorta and renal arteries, abdominal angiography of renal arteries or MR angiography of renal arteries and abdominal aorta), 4 - DM1 patients with DN (n=30). Clinical examination included assessment of complaints, analysis of medical history of the main diseaseand concomitant disorders, determination of the main clinical and biochemical characteristics of blood and urine, measurement of НbА1с and 24-hralbuminuria (AU) by standard methods, estimation of GFR by the MDRD formula, ECG, echocardiography, 24-hr AP monitoring, counseling bycardiologist and ophthalmologist (fundal examination by ophthalmoscopy). Standard kits were used to detect profibrogenic mediators and markersof endothelial dysfunction including transforming growth factor-beta (TGF-b), angiotensin II (AT II), monocyte chemoattractant protein (MCP-1),regulated on activation normal T cell expressed and secreted (RANTES), adhesion factors (intracellular adhesion molecule (ICAM-1), vascular celladhesion molecule (VCAM-1) vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), asymmetric dimethylargnine (ADMA), homocysteine(HCYST), metalloproteinases (MMP), von Willebrand factor (vWF), plasminogen activator inhibitor (PAI-I). Results. DM patients with CKD had elevated blood profibrogenic cytokine (MCP-1, TGF-1b, IL-6) and extracellular matrix degradation factor(MMP-9) levels compared with patients without CKD and healthy subjects. These changes were unrelated to the type of diabetes or the cause ofnephropathy, which suggests their contribution to renal pathology through the universal mechanism of tubulointerstitial fibrosis. Activation of profibrogeniccytokines in DM patients with CKD was closely associated with endothelial dysfunction manifest as enhanced production of blood adhesive angiogenic, thrombogenic factors (FW, PAI, VICAM, sICAM, VEGF), and endothelium-affecting factors (ADMA, homocysteine). Mediators of inflammationand fibrogenesis in these patients negatively correlated with GFR and positively with AU, the main markers of renal dysfunction. Hyperuricemia,TGF-1b, ADMA, and MCP-1 are considered to be the risk factors of impaired renal filtration function. Conclusion. The level of profibrogenic cytokines and ndothelial dysfunction factors in DM patients with different renal lesions reflects severity of tubulointerstitialfibrosis. It may be used for the purpose of prognostication and substantiation of intensification of secondary prophylaxis of renal insufficiency.

The clinical and instrumental rationale for the choice of therapy of arterial hypertension in the patients presenting with diabetes mellitus

2013 ◽  
Vol 58 (6) ◽  
pp. 8-12
Author(s):  
I. P. Tatarchenko ◽  
N. V. Pozdnyakova ◽  
A. G. Mordovina
Keyword(s):  
Diabetes Mellitus ◽  
Arterial Hypertension ◽  
Diastolic Heart Failure ◽  
Angiotensin Ii Receptor ◽  
Vasomotor Function ◽  
Patients With Diabetes ◽  
Hemodynamic Characteristics ◽  
Arterial Endothelium ◽  
Choice Of Therapy

Cardiovascular disorders are the main cause of high disability and mortality rates among the patients with diabetes mellitus. The objective of the present work was to estimate the clinical and hemodynamic characteristics during the treatment of arterial hypertension with the use of olmesartan (hypertension/angiotensin II receptor antagonist, ARA) in the patients with type 2 diabetes mellitus suffering diastolic heart failure. The study included 56 patients (26 men and 30 women) of the mean age 58.2±5.3 years. They were given a course of olmesartan (cardosal) therapy 40 weeks in duration. This treatment was shown to result in positive dynamics of structural and geometric characteristics of the left ventricle and its diastolic function in conjunction with the improvement of the vasomotor function of arterial endothelium.

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