Renal hyperfiltration and arterial stiffness in humans with uncomplicated type 1 diabetes.
OBJECTIVE
We have reported that renal hyperfiltration is associated with endothelial dysfunction in early type 1 diabetes. However, the relationship between renal hyperfiltration and arterial stiffness is unknown. Accordingly, we measured arterial stiffness in type 1 diabetic subjects with hyperfiltering (n = 20) or normofiltering (n = 18).


METHODS
Augmentation index (AIx), aortic pulse wave velocity (PWV), renal hemodynamic function (inulin and paraaminohippurate clearances), and urinary and circulating plasma cGMP were measured in normoalbuminuric subjects with type 1 diabetes during clamped euglycemia (glucose 4-6 mmol/l) and hyperglycemia (glucose 9-11 mmol/l).


RESULTS
During clamped euglycemia, hyperfiltering subjects (glomerular filtration rate >or=135 ml/min/1.73 m(2)) exhibited lower AIx values (-6.1 +/- 2.9 vs. 13.9 +/- 2.7%, P = 0.001) and higher cGMP levels in urine and plasma compared with normofiltering subjects. These differences were maintained during clamped hyperglycemia. As expected, renal hemodynamic responses to clamped hyperglycemia were exaggerated in normofilterers, but values for AIx remained unchanged.


CONCLUSIONS
Renal hyperfiltration is associated with reduced arterial stiffness in subjects with uncomplicated type 1 diabetes.
Cherney
David Z I
DZ
Toronto General Hospital, Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. david.cherney@uhn.on.ca
Sochett
Etienne B
EB
Lai
Vesta
V
Dekker
Maria G
MG
Slorach
Cameron
C
Scholey
James W
JW
Bradley
Timothy J
TJ
D001158:Arteries / Q000473:pathology* / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D005919:Glomerular Filtration Rate / Q000502:physiology; D015309:Glucose Clamp Technique; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology*