title: Influence of sex on hyperfiltration in patients with uncomplicated type 1 diabetes.
abstract: The aim of this analysis was to examine sex-based differences in renal segmental resistances in healthy controls (HCs) and patients with type 1 diabetes (T1D). We hypothesized that hyperfiltration-an early hemodynamic abnormality associated with diabetic nephropathy-would disproportionately affect women with T1D, thereby attenuating protection against the development of renal complications. Glomerular hemodynamic parameters were evaluated in HC (n= 30) and in normotensive, normoalbuminuric patients with T1D and either baseline normofiltration [n= 36, T1D-N, glomerular filtration rate (GFR) 90-134 ml·min-1·1.73 m2] or hyperfiltration (n= 32, T1D-H, GFR ≥ 135 ml·min-1·1.73 m2) during euglycemic conditions (4-6 mmol/l). Gomez's equations were used to derive efferent (RE) and afferent (RA) arteriolar resistances, glomerular hydrostatic pressure (PGLO) from inulin (GFR) and paraaminohippurate [effective renal plasma flow (ERPF)] clearances, plasma protein and estimated ultrafiltration coefficients (KFG). Female patients with T1D with hyperfiltration (T1D-H) had higher RE(1,985 ± 487 vs. 1,381 ± 296 dyne·sec-1·cm-5,P< 0.001) and filtration fraction (FF, 0.20 ± 0.047 vs. 0.16 ± 0.03P< 0.05) and lower ERPF (876 ± 245 vs. 1,111 ± 298 134 ml·min-1·1.73 m2P< 0.05) compared with male T1D-H patients. Overall, T1D-H patients had higher PGLOand lower RAvs. HC subjects, although there were no sex-based differences. In conclusion, female T1D-H patients had higher REand FF and lower ERPF than their male counterparts with no associated sex differences in RAProspective intervention studies should consider sex as a modifier of renal hemodynamic responses to renal protective therapies.
authors.affiliation: Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Marko
authors.initials: M
authors.lastname: Škrtić
authors.affiliation: Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.|Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Yuliya
authors.initials: Y
authors.lastname: Lytvyn
authors.affiliation: Department of Pediatric Endocrinology, Barbara Davis Center for Diabetes University of Colorado School of Medicine, Aurora, CO.
authors.forename: Petter
authors.initials: P
authors.lastname: Bjornstad
authors.affiliation: Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Heather N
authors.initials: HN
authors.lastname: Reich
authors.affiliation: Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: James W
authors.initials: JW
authors.lastname: Scholey
authors.affiliation: University Health Network, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Yip
authors.affiliation: Department of Pediatrics, Division of Endocrinology, Sickkids Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Etienne B
authors.initials: EB
authors.lastname: Sochett
authors.affiliation: Department of Medicine, Division of Endocrinology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Bruce
authors.initials: B
authors.lastname: Perkins
authors.affiliation: Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada; david.cherney@uhn.ca.|Department of Medicine, Division of Endocrinology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.|Department of Physiology, University of Toronto, Toronto, Ontario, Canada; and.|Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: David Z I
authors.initials: DZ
authors.lastname: Cherney
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006439:Hemodynamics; D006801:Humans; D007678:Kidney Glomerulus / Q000098:blood supply*; D008297:Male; D008954:Models, Biological; D017596:Renal Plasma Flow, Effective; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014655:Vascular Resistance; D055815:Young Adult
keywords: glomerular hemodynamics; hyperfiltration; sex; type 1 diabetes