Urinary kallikrein excretion in type 1 (insulin-dependent) diabetes mellitus.
Kidney haemodynamics appear to change after the early phases of diabetic nephropathy: increases in glomerular filtration rate and in renal plasma flow have been widely reported, while kidney size is increased. As the renal kallikrein-kinin system has been demonstrated to regulate kidney blood circulation, we have evaluated the excretion of urinary kallikrein in 87 Type 1 (insulin-dependent) diabetic patients with and without hyperfiltration. Urinary kallikrein excretion was measured in 24-h urine collections. The esterolytic activity was determined by fluorimetric assay. The excretion of urinary kallikreins was significantly higher in hyperfiltering patients (472 +/- 125 esterase units/24 h) than in normofiltering (168 +/- 77 esterase units/24 h) and control subjects (151 +/- 39 esterase units/24 h), p < 0.001. Furthermore, we observed a positive correlation between urinary kallikrein excretion and glomerular filtration rate (r = 0.785). These data suggest that variations of kallikrein and kinin concentrations may play a role in the alteration of renal haemodynamics in Type 1 diabetes. It is possible that the kinin-kallikrein system, the renin-angiotensin system and the prostaglandins may interact to determine the haemodynamic alterations which are present in the diabetic disease.
Manto
A
A
Istituto Clinica Medica, Rome, Italy.
Cotroneo
P
P
Porcelli
G
G
D'Errico
G
G
Marra
G
G
Magnani
P
P
Tilli
P
P
Greco
A V
AV
Ghirlanda
G
G
D000328:Adult; D015415:Biomarkers / Q000652:urine; D001794:Blood Pressure; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000201:enzymology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000201:enzymology / Q000652:urine*; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007610:Kallikreins / Q000652:urine*; D008297:Male; D012016:Reference Values
D015415:Biomarkers; D003404:Creatinine; D006442:Glycated Hemoglobin; D007610:Kallikreins