Delayed graft function: utility of predictive models.
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Graft Survival↗
Biomedical subjects
C Kubal
Publications and source records attributed to C Kubal.
Nutrient intake in insulin-dependent diabetic patients with incipient nephropathy.
The onset of diabetic nephropathy is characterized by subclinical elevation of urinary albumin excretion, so-called 'microalbuminuria' (M). Dietary assessments were carried out in 15 insulin-dependent diabetic patients with persistent M and an equal number with persistently normal albumin excretion. The groups were matched for sex, age, duration of diabetes, body mass index, insulin dose and glycosylated haemoglobin; there were no significant differences in systemic blood pressure, glomerular filtration rate, blood glucose and serum albumin concentrations between the groups; retinopathy was significantly more frequent in patients with M. Diabetics with persistent M were found to consume a significantly larger amount of fat (expressed as grams and percentage of total energy) and a significantly smaller percentage of total energy as carbohydrate than patients with normal albumin excretion; total dietary energy was larger in those with persistent M, but the difference was not significant. No significant differences were found in protein and fibre intakes between the groups. Our findings suggest that an excess in the dietary consumption of fat relative to carbohydrate might play an important role in the pathogenesis of early nephropathy in insulin-dependent diabetes mellitus. We emphasize the importance of careful attention to nutrient intake in the prevention and treatment of diabetic complications.
Adult↗
Long-term variation of urinary albumin excretion in insulin-dependent diabetes mellitus: some practical recommendations for monitoring microalbuminuria.
Seven measurements of albumin excretion in overnight, recumbent (OR) and daytime, ambulant (DA) urine samples were carried out at successive intervals of 3 months in 172 insulin-dependent diabetic patients; at entry into the study, all had a resting albumin excretion rate less than 300 micrograms/min. Urinary albumin excretion in both collections was expressed as a concentration (UA, mg/l), as a creatinine ratio (UA/UC, mg/mmol) and as an excretion rate (UAV, micrograms/min). The pooled within-subject standard deviation (log. (base e) transformed data) for each expression of the albumin excretion was: (1) OR sample--UA 0.6824 mg/l, UA/UC 0.5257 mg/mmol, UAV 0.5940 micrograms/min; (2) DA sample--UA 0.7830 mg/l, UA/UC 0.5780 mg/mmol, UAV 0.6334 micrograms/min. The results were used to calculate the 95% range for a difference between two measurements within an individual patient which was lowest with OR UA/UC (chi/divided by 4.42) and highest with the DA UA (chi/divided by 9.16). Variation in the OR sample was also studied in terms of the patterns of microalbuminuria (M; UAV greater than 15 micrograms/min) which were found to be closely associated with the initial level of albumin excretion: persistent non-M was most common in patients with a baseline UAV less than 15 micrograms/min; established M was most common in those with a baseline UAV greater than 70 micrograms/min, some of whom developed clinical albuminuria. The frequency with which patients should be re-screened for M may be determined by the initial value of albumin excretion and by the threshold used to define M.
Adult↗
Serum lipids and lipoproteins in insulin-dependent diabetic patients with persistent microalbuminuria.
Serum lipid and lipoprotein concentrations were measured in 18 insulin-dependent diabetic patients with persistent microalbuminuria and an equal number with persistently normal albumin excretion. The groups were matched for sex, age, duration of diabetes, body mass index, insulin dose, and glycosylated haemoglobin. Diabetic patients with persistent microalbuminuria were found to have a significantly lower high density lipoprotein (HDL) cholesterol concentration (difference 0.29, 95% Cl 0.12 to 0.46, mmol l-1, p less than 0.01) and a higher low density lipoprotein (LDL) cholesterol:HDL cholesterol ratio (difference 0.97, 95% Cl 0.29 to 1.65, p less than 0.01) than patients with normal albumin excretion. No significant differences were found in total cholesterol, triglycerides, LDL cholesterol, apolipoprotein (apo) A-I and apo B concentrations. Compared to an age and sex-matched group of non-diabetic subjects with normal albumin excretion, diabetic patients with persistent microalbuminuria had significantly higher concentrations of total cholesterol (p less than 0.05), LDL cholesterol (p less than 0.05) and apo B (p less than 0.01), but a lower concentration of HDL cholesterol (p less than 0.05). No significant differences were found in serum lipids and lipoproteins between diabetic patients with normal albumin excretion and non-diabetic subjects.
Albuminuria↗