Intrarenal arteriosclerosis and impairment of kidney function in NIDDM subjects

It is currently under debate whether the pathogenesis of end-stage renal failure in non-insulin-dependent diabetes mellitus (NIDDM) is a consequence of microangiopathy alone. The aim of this study was to investigate intrarenal arteriosclerosis and its correlation with kidney function in NIDDM. In 36...

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Published in:Diabetologia 1998-01, Vol.41 (1), p.121-124
Main Authors: BOERI, D, DERCHI, L. E, MAIELLO, M, MARTINOLI, C, SIMONI, G, SAMPIETRO, L, STORACE, D, PONTE, L, CALVI, C, REPETTO, M, ROBAUDO, C
Format: Article
Language:English
Subjects:
Arteriosclerosis - blood
Arteriosclerosis - physiopathology
Biological and medical sciences
Blood Pressure
Body Mass Index
Cholesterol, LDL - blood
Creatinine - metabolism
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - physiopathology
Diabetes. Impaired glucose tolerance
Diabetic Angiopathies - blood
Diabetic Angiopathies - physiopathology
Diabetic Nephropathies - blood
Diabetic Nephropathies - physiopathology
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Female
Glycated Hemoglobin A - analysis
Humans
Kidney - anatomy & histology
Kidney - blood supply
Kidney - physiopathology
Male
Medical sciences
Middle Aged
Renal Artery - diagnostic imaging
Ultrasonography, Doppler, Duplex
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Summary:It is currently under debate whether the pathogenesis of end-stage renal failure in non-insulin-dependent diabetes mellitus (NIDDM) is a consequence of microangiopathy alone. The aim of this study was to investigate intrarenal arteriosclerosis and its correlation with kidney function in NIDDM. In 36 diabetic subjects, and in 10 age- and sex-matched healthy control subjects we measured kidney volume and resistive index of the interlobar arteries by duplex Doppler ultrasonography. Clinical and metabolic parameters, renal function and vascular sequelae of the disease were also evaluated. In diabetic subjects resistive index (median 0.72, range 0.54-0.79) was higher than in control subjects (median 0.62, range 0.57-0.66) (2p < 0.002). Kidney volume and resistive index correlated with age (p < 0.004), body mass index (p < 0.001), mean blood pressure (p < 0.001), total and LDL cholesterol (p < 0.01) and creatinine clearance (p < 0.001 and < 0.01, respectively). Kidney volume also correlated with HbA1 (p < 0.01) and resistive index with uric acid (p < 0.01). Lower body macroangiopathy was associated with increased resistive index and reduced kidney volume (2p < 0.05), while upper body macroangiopathy and microangiopathy were not. Our data suggest that macroangiopathy rather than microangiopathy is mainly responsible for impairment of kidney function in NIDDM. The resistive index of interlobar arteries seems to be a reliable marker of intrarenal arteriosclerosis and can be used as a non-invasive, easily available parameter of its evolution.
ISSN:0012-186X
1432-0428
DOI:10.1007/s001250050877