[Influence of blood pressure level on urinary albumin excretion rate and erythropoietin production in diabetic patients].
The purpose of this study was to investigate blood pressure variations during diabetic incipient nephropathy and to evaluate theirs consequences for erythropoietin (EPO) production.


METHODS
This study included 94 diabetic patients (mean age: 59.9 +/- 15.3 years, diabetes duration: 13.8 +/- 15.3 years). Patients were divided in two groups according to urinary albumin excretion rate (UAE): group 1: UAE <30 mg/24 hrs, N=64 and group 2: 30<UAE <300 mg/24 hrs; N=30 EPO levels and 24 hrs ABPM where compared between these two groups.


RESULTS
patients' age and BMI, diabetes duration and Hb A1c levels, blood pressure and creatinine clairance did not differ from significant manner between the two groups. 24 hrs BP and daytime BP did not differ according to UAE rate. Night-time BP was significantly higher in group 2 than in group 1 (SBP: 126 +/- 17 vs. 118 +/- 15 mmHg, p<0.04 and DBP: 71 +/- 10 vs. 67 +/- 8 mmHg, p < 0.02). UAE was positively correlated nigh-time BP (r = 0.263, p = 0.01 for SBP and r = 0.273, p = 0.008 for DBP) and negatively with the difference between daytime and night-time SBP (delta SBP) (r = -0.205, p < 0.05). Hemoglobin levels did not differ significantly between the two groups. EPO levels of group 2 were significantly lower than those of group 1 (15.1 +/- 5.6 vs. 17.7 +/- 6.2 mU/ml, p < 0.05). A negative correlation between UAE and EPO was found (r = -0.266, p < 0.01). UAE and delta SBP explained 12.2% of EPO variance.


CONCLUSIONS
in diabetic patients, elevation of night-time BP and reduction in nightime BP fall participate to the installation of incipient nephropathy. A significant decrease in EPO production is noted in the same time.
Bordier
L
L
Service d'endocrinologie, hôpital d'instruction des Armées Bégin, Saint-Mandé.
Le Berre
J P
JP
Garcia
C
C
Dupuy
O
O
Mayaudon
H
H
Bauduceau
B
B
D000419:Albuminuria / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D002940:Circadian Rhythm / Q000502:physiology; D003928:Diabetic Nephropathies / Q000652:urine*; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D004921:Erythropoietin