[Microalbuminuria in insulin-dependent diabetics: the prevention of diabetic nephropathy].
We evaluated the effects of angiotensin converting enzyme inhibition upon the urinary excretion of albumin in 36 insulin dependent normotensive diabetic patients with adequate metabolic control and no evidence of renal failure. 19 subjects had normal levels of albumin excretion (< 30 mg/24 h) and 17 showed microalbuminuria from 30 to 300 mg/24 h. Half of the patients were randomly selected in each group to receive enalapril, 5 mg/day. A progressive decrease in albumin excretion levels was observed for both enalapril treated subgroups, from 18.9 +/- 8.3 to 8.1 +/- 2.7 mg/24 h (normoalbuminurics) and from 73.1 +/- 25.0 to 40.1 +/- 26.3 mg/24 h (microalbuminurics). In contrast, an increase in albumin excretion from 19.4 +/- 6.8 to 29.4 +/- 14.2 mg/24 h was observed in non treated normoalbuminuric patients. Untreated patients with microalbuminuria remained with stable albumin excretion levels (67.4 +/- 39 to 64.8 +/- 23.4 mg/24 h). Enalapril treatment was associated to a significant (p < 0.05) decrease in creatinine clearance which remained within normal limits. Blood pressure, Na and K plasma levels and total proteins remained normal throughout the study. Thus, angiotensin converting enzyme inhibition reduces the urinary excretion of albumin in insulin dependent diabetics with normo or microalbuminuria.
Durruty
P
P
Unidad de Diabetes y Nutrición, Facultad de Medicina, Universidad de Chile (División Occidente) Hospital San Juan de Dios, Santiago.
Krause
P
P
Pérez
F
F
García de los Ríos
M
M
López
G
G
Durruty
G
G
D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000188:drug therapy / Q000453:epidemiology / Q000652:urine*; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000453:epidemiology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000517:prevention & control* / Q000652:urine; D004044:Dietary Proteins / Q000008:administration & dosage; D004656:Enalapril / Q000627:therapeutic use; D006801:Humans
D001786:Blood Glucose; D004044:Dietary Proteins; D004656:Enalapril
Microalbuminuria en diabéticos insulinodependientes: prevención de la nefropatía diabética.