Renal scintigraphy in insulin-dependent diabetes mellitus: Early glomerular and urologic dysfunction

Journal Article · Sun Jul 01 04:00:00 EDT 1990 · Journal of Diabetic Complications; (USA)

DOI:https://doi.org/10.1016/0891-6632(90)90050-F· OSTI ID:5987652

Poirier, J Y; Moisan, A; Le Cloirec, J; Siemen, C; Yaouanq, J; Edan, G; Herry, J Y ^[1]

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1. Clinique Medicale B, Hopital-Sud, Rennes (France)

Glomerular filtration rate (GFR) and renal plasma flow (RPF) were measured by intravenous injection of 99mTc-diethylenetriaminepentaacetic acid (DTPA) and 131I-Hippuran in 115 insulin-dependent diabetic patients with albumin excretion rates (AER) less than 200 micrograms/min, and in 45 normal subjects. Separate kidney function and urinary elimination were estimated by renography. GFR was increased in the diabetic patients (152 +/- 24 ml/min/1.73 m2 vs. 128 +/- 15) and correlated significantly with RPF (r = 0.5; p less than 10(-9)). No relationship was found between GFR and the duration of diabetes, blood glucose, HbA1c, or AER. Fifty patients were hyperfiltering with RPF and filtration fraction higher than those in the normofiltering group. Slow intrarenal or pyeloureteral elimination, either unilateral or bilateral, was observed in 3 controls and 60 diabetic subjects (24 hyperfiltering; 36 normofiltering) and did not disappear with the patient in the standing position. In these 60 patients, mean age, duration of diabetes, blood glucose, HbA1c, 24 h albumin excretion rate, and frequency of peripheral or autonomic neuropathy did not differ from patients with normal scintigraphy; GFR was lower in the group with slow elimination, but not significantly so. 99mTc-DTPA renal uptake was symmetric in all the controls; asymmetric renal uptake with asymmetric GFR was observed in 13 patients (7 hyperfiltering; 6 normofiltering) and often associated with slower elimination. No evidence for renal stenotic atheroma or parenchymatous disease was found on the angiopyleoureterography. The results suggest that incipient uropathy is a very common phenomenon that occurs irrespective of glomerular dysfunction.

• OSTI ID: 5987652
• Journal Information: Journal of Diabetic Complications; (USA), Journal Name: Journal of Diabetic Complications; (USA) Vol. 4:3; ISSN JDCOE; ISSN 0891-6632
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
AMINO ACIDS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CARBOXYLIC ACIDS
CHELATING AGENTS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIABETES MELLITUS
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
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ENDOCRINE DISEASES
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
IODINE 131
IODINE ISOTOPES
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
KIDNEYS
METABOLIC DISEASES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOPROTECTIVE SUBSTANCES
SCINTISCANNING
TECHNETIUM 99
TECHNETIUM ISOTOPES
UROGENITAL SYSTEM DISEASES
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