[Changes in renal protein excretion and kidney function in type I diabetic patients during and following pregnancy in relation to the stage of preexistent diabetic nephropathy].
In 14 female type I diabetics the influence of preexisting diabetic nephropathy on the behaviour of proteinuria and renal function during and after pregnancy was investigated. We compared albumin and total protein in urine, serum-creatinine, creatinine-clearance, uric acid and beta 2-microglobulin in serum before, during and up to sixth months after pregnancy in 5 diabetic women with preexisting normo-albuminuria, stage II of diabetic nephropathy, in 6 women with microalbuminuria, stage III, and in 3 women with overt proteinuria, stage IV of diabetic nephropathy (by Mogensen); in this last patient-group there was a heavy proteinuria with decreased creatinine clearance and high blood pressure still before the begin of the pregnancy. The albumin- and total protein excretion in urine showed in all diabetic patients a 3- to 8-fold increase during pregnancy and in all cases the increased proteinuria dropped after pregnancy to the preexisting values. A transient nephrotic syndrome in pregnancy developed in 2/6 diabetic women with primary microalbuminuria and in all 3 patients with overt proteinuria, but not in any case of pregnant women with primary normo-albuminuria; the difference between the absolute increase of proteinuria in the 2 patient-groups with stage II and III of diabetic nephropathy was statistically significant (p less than 0.005). The renal function parameters serum-creatinine and creatinine-clearance showed in all pregnant women with stage II or III of diabetic nephropathy the same transient changes as in non-diabetic pregnant women, the mean serum-creatinine concentration showed a decline of 36% respectively 14%, the creatinine clearance an increase of 31% and 36%.(ABSTRACT TRUNCATED AT 250 WORDS)
II. Medizinische Abteilung, Allgemeinen Krankenhauses der Stadt Linz.
G
G
Biesenbach
W
W
Stöger
J
J
Zazgornik
D000293:Adolescent; D000328:Adult; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis*; D003928:Diabetic Nephropathies / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007677:Kidney Function Tests; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000175:diagnosis*; D011507:Proteinuria / Q000175:diagnosis*
D003404:Creatinine; D006442:Glycated Hemoglobin
Anderungen der renalen Eiweissausscheidung und der Nierenfunktion bei Typ I Diabetikerinnen während und nach einer Gravidität in Abhängigkeit vom Stadium einer präexistenten diabetischen Nephropathie.