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Glycosuria amount in response to hyperglycaemia and risk for diabetic kidney disease and related events in Type 1 diabetic patients

dc.rights.licenseopenen_US
dc.contributor.authorCARPENTIER, C.
dc.contributor.authorDUBOIS, S.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorMOHAMMEDI, Kamel
dc.contributor.authorBELHATEM, N.
dc.contributor.authorBOUHANICK, B.
dc.contributor.authorROHMER, V.
dc.contributor.authorBRIET, C.
dc.contributor.authorBUMBU, A.
dc.contributor.authorHADJADJ, S.
dc.contributor.authorROUSSEL, R.
dc.contributor.authorPOTIER, L.
dc.contributor.authorVELHO, G.
dc.contributor.authorMARRE, M.
dc.date.accessioned2020-06-03T14:25:00Z
dc.date.available2020-06-03T14:25:00Z
dc.date.issued2019
dc.identifier.issn1460-2385 (Electronic) 0931-0509 (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/7730
dc.description.abstractEnBackground: Hyperglycaemia impairs tubulo-glomerular feedback. We tested whether variable tubulo-glomerular feedback during hyperglycaemia contributes to renal risk heterogeneity seen in Type 1 diabetes. Methods: During the period 1990-92, we studied the tubulo-glomerular feedback in Type 1 diabetic patients at high or low renal risk [21 of 54 with glomerular hyperfiltration and/or microalbuminuria against 11 of 55 with normal glomerular filtration rate (GFR) and urinary albumin despite uncontrolled diabetes]. The GFR, effective renal plasma flow, mean arterial pressure and fractional reabsorptions of glucose, osmols, sodium and lithium were measured sequentially during normo- and hyperglycaemia. All patients were followed up until 2016 for incident proteinuria, estimated GFR <60 mL/min/1.73 m2, doubling of serum creatinine, end-stage renal disease or all-cause death. Results: Glycaemia increased from 6.1 +/- 1.3 to 15.1 +/- 1.9 mmol/L in both high-risk and low-risk patients. Glycosuria was lower in the high- versus low-risk patients: 0.34 +/- 0.25 versus 0.64 +/- 0.44 mmol/min (P = 0.03). Both groups displayed similar kidney function during normoglycaemia. Hyperglycaemia increased more importantly GFR and fractional reabsorptions, and pre-glomerular vasodilatation in the high- than in the low-risk patients (all P < 0.05). Over 21 years, 31.5% high- versus 12.7% low-risk patients developed endpoints (adjusted P = 0.006). In a multi-adjusted survival analysis of patients having undergone renal tests, each 0.10 mmol/min glycosuria during hyperglycaemia reduced the outcome risk by 0.72 (95% confidence interval 0.49-0.97, P = 0.03). Conclusions: Reduced tubulo-glomerular feedback and glycosuria during hyperglycaemia indicate high renal risk for Type 1 diabetic patients. Inter-individual variability in tubulo-glomerular feedback activity determines renal risk in Type 1 diabetes.
dc.language.isoENen_US
dc.title.enGlycosuria amount in response to hyperglycaemia and risk for diabetic kidney disease and related events in Type 1 diabetic patients
dc.title.alternativeNephrol Dial Transplanten_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/ndt/gfy197en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed29982607en_US
bordeaux.journalNephrology, dialysis, transplantationen_US
bordeaux.page1731-1738en_US
bordeaux.volume34en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue10en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
bordeaux.COinSctx_ver=Z39.88-2004&amp;rft_val_fmt=info:ofi/fmt:kev:mtx:journal&amp;rft.jtitle=Nephrology,%20dialysis,%20transplantation&amp;rft.date=2019&amp;rft.volume=34&amp;rft.issue=10&amp;rft.spage=1731-1738&amp;rft.epage=1731-1738&amp;rft.eissn=1460-2385%20(Electronic)%200931-0509%20(Linking)&amp;rft.issn=1460-2385%20(Electronic)%200931-0509%20(Linking)&amp;rft.au=CARPENTIER,%20C.&amp;DUBOIS,%20S.&amp;MOHAMMEDI,%20Kamel&amp;BELHATEM,%20N.&amp;BOUHANICK,%20B.&amp;rft.genre=article


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