Renal Hemodynamics and Albumin Excretion Rate in Patients With Diabetes Secondary to Acquired Pancreatic Disease

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Abstract
OBJECTIVE To assess kidney function and AER in patients with PD. RESEARCH DESIGN AND METHODS Thirty-three patients with PD (age 52 ± 7 yr, duration of disease 11 ± 6 yr, BMI 24 ± 3 kg/m2) and 33 patients with IDDM were matched for sex, BMI, and duration of disease. GFR and RPF were determined by single injection of [51Cr]EDTA and [125I]hippurate. AER was measured by radioimmunoassay in a single timed overnight urine collection. RESULTS GFR and RPF were, respectively, 113 ± 35 and 441 ± 145 ml · min−1 · 1.73 m2 in patients with PD and 123 ± 30 and 549 ± 94 (P < 0.001) in IDDM. FF was significantly higher in patients with PD (0.26 ± 0.05 vs. 0.22 ± 0.03; P < 0.001). Prevalence of hyperfiltration (GFR > 135 ml · min−1 · 1.73 m2) was similar in both groups (30% in patients with PD vs. 28% in those with IDDM). Geometric mean of urinary AER was 10.4 μg/min (range 1–186) in patients with PD and 11.2 (1–198) in IDDM patients. Some 30.3% of patients with PD and 18% of those with IDDM were microalbuminuric (AER > 20 μg/min). By multiple regression analysis, AER was significantly related to systolic (P < 0.04) and diastolic blood pressure (P < 0.01) and to BMI (P < 0.03) in patients with PD. Retinopathy was more frequent in microalbuminuric patients with PD than in those without elevated AER. CONCLUSIONS We suggest that early renal abnormalities occur similarly in patients with PD and IDDM.

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