title: Relationship between urinary excretion of fibronectin degradation products and proteinuria in diabetic patients, and their suppression after continuous subcutaneous heparin infusion.
abstract: To explore the possibility that the excretion of urinary fibronectin degradation products (U-FnDP) can be an indicator of the progression of diabetic nephropathy, U-FnDP and urinary protein(U-P) were determined in 64 diabetic patients and 11 healthy volunteers. Moreover, to determine whether continuous subcutaneous heparin infusion (CSHI) reduces elevated U-FnDP and U-P in diabetic patients with persistent proteinuria, heparin sodium was administered as a bolus subcutaneous injection of 5000 IU, followed by subcutaneous infusion of 250 IU/kg per 24 h heparin sodium for 7 days. U-FnDP excretion rate elevated proportionally to the degree of U-P. CSHI reduced significantly elevated U-FnDP from 172.68 +/- 15.79 to 100.04 +/- 14.93 micrograms/24 h (P < 0.01) and U-P from 1.76 +/- 0.13 to 1.20 +/- 0.12 g/24 h (P < 0.01). No significant changes in blood pressure and diurnal mean plasma glucose levels were found. APTT was prolonged with a decrease of AT-III activity during the treatment. These findings suggest that U-FnDP can be one of the indicators which reflects the degree of progression of diabetic nephropathy, and that CSHI may be useful for the normalization of elevated U-FnDP and reduction in U-P in diabetic nephropathy.
authors.affiliation: Second Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kuboki
authors.forename: H
authors.initials: H
authors.lastname: Tada
authors.forename: K
authors.initials: K
authors.lastname: Shin
authors.forename: Y
authors.initials: Y
authors.lastname: Oshima
authors.forename: S
authors.initials: S
authors.lastname: Isogai
mesh_terms: D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000032:analysis / Q000378:metabolism; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D003404:Creatinine / Q000097:blood; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000378:metabolism / Q000652:urine*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005353:Fibronectins / Q000378:metabolism / Q000652:urine*; D006493:Heparin / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011507:Proteinuria / Q000150:complications*; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D005353:Fibronectins; D000990:Antithrombin III; D006493:Heparin; D003404:Creatinine