Postexercise albuminuria in children with different duration of type-1 diabetes mellitus

About 30% of diabetic patients develop progressive renal failure. We studied albumin, IgG, and transferrin excretion during exercise in diabetic children without signs of nephropathy to investigate proteinuria under these conditions: 39 patients with insulin-dependent diabetes mellitus and 21 health...

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Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 1996-10, Vol.10 (5), p.594-597
Main Authors: KRÜGER, M, GORDJANI, N, BURGHARD, R
Format: Article
Language:English
Subjects:
Adolescent
Adult
Albuminuria - etiology
Associated diseases and complications
Biological and medical sciences
Child
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 1 - metabolism
Diabetes. Impaired glucose tolerance
Diabetic Nephropathies - etiology
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Exercise
Female
Glomerulonephritis
Humans
Male
Medical sciences
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Renal Insufficiency - etiology
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Summary:About 30% of diabetic patients develop progressive renal failure. We studied albumin, IgG, and transferrin excretion during exercise in diabetic children without signs of nephropathy to investigate proteinuria under these conditions: 39 patients with insulin-dependent diabetes mellitus and 21 healthy children undertook a bicycle exercise test. Albuminuria measured by nephelometry was calculated as the albumin excretion rate (AER) and albumin-to-creatinine ratio before and after exercise. The diabetic group was divided into three subgroups according to disease duration (DI < 5 years, DII 5-10 years, DIII > 10 years). No significant difference in metabolic control (hemoglobin A1c was detected between the diabetic groups (median hemoglobin A1c: DI 7.2%, DII 7.6%, DIII 8.6%). There was no increase in AER in the healthy children after exercise. Before exercise the diabetic groups had an AER similar to controls. No significant increase in albuminuria after exercise was seen in group DI. Both groups with a disease duration of more than 5 years had a significant increase in albuminuria [median before/after: DII 7.8/16.7 (P < 0.05), DIII 0/57.9 (P < 0.05) micrograms/min per 1.73 m2). Of these patients, 43% also had a measurable urinary excretion of IgG and transferrin, indicating structural glomerular damage. There was no correlation of albuminuria and parameters of metabolic control or renal function. We conclude that in diabetic children an exercise test unveils albuminuria in certain patients, while their AER may be normal at rest.
ISSN:0931-041X
1432-198X
DOI:10.1007/s004670050168