Renal effects of prostaglandin E1 in type 2 (non-insulin-dependent) diabetic patients with subclinical nephropathy.
To determine whether the urinary albumin excretion rate (UAER) could be reduced without adversely affecting renal function, prostaglandin E1 (PGE1) was administrated to Type 2 (non-insulin-dependent) diabetic patients with both high and low microalbuminuria, who were matched for age, weight, height and hemoglobin A1c levels. The study was performed as a randomized double-blind trial, with the patients receiving either PGE1 or placebo. In patients who initially had a UAER above 30 mug/min (high UAER group), the UAER was significantly (p less than 0.01) reduced by the administration of PGE1. In this group the UAER after stopping PGE1 administration was comparable to baseline values. During PGE1 administration in the high UAER group, the filtration fraction (FF) was significantly reduced (p less than 0.01) while the glomerular filtration rate (GFR) was unchanged. In patients with an initial UAER below 30 mug/min (low UAER group) the UAER was not altered during the administration of PGE1. In this low UAER group both the FF and GFR remained unchanged. The urinary beta2-microglobulin excretion rate did not change significantly during the administration of PGE1 in either group. These results suggest that the decreased UAER in patients with an abnormally high albumin excretion, may be due to a change in the glomerular permeability to albumin related to a decreased FF.
Ninomiya
Y
Y
Department of Medicine (II), Niigata University, School of Medicine, Japan.
Arakawa
M
M
D000419:Albuminuria / Q000188:drug therapy*; D000527:Alprostadil / Q000627:therapeutic use*; D001794:Blood Pressure; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000188:drug therapy / Q000503:physiopathology*; D004311:Double-Blind Method; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D011897:Random Allocation; D012079:Renal Circulation / Q000187:drug effects*; D001613:beta 2-Microglobulin / Q000652:urine
D000527:Alprostadil; D006442:Glycated Hemoglobin; D001613:beta 2-Microglobulin