| Authors |
Piani F, Reinicke T, Lytvyn Y, Melena I, Lovblom LE, Lai V, Tse J, Cham L,
Orszag A, Perkins BA, Cherney DZI, Bjornstad P
|
| Submitted By |
Petter Bjornstad on 5/5/2021 |
| Status |
Published |
| Journal |
Journal of diabetes and its complications |
| Year |
2021 |
| Date Published |
3/1/2021 |
| Volume : Pages |
35 : 107807 |
| PubMed Reference |
|
| Abstract |
Arginine vasopressin (AVP) and its surrogate, copeptin, have been implicated in
diabetic kidney disease (DKD) pathogenesis, which develops in a subset of people
with longstanding type 1 diabetes, but not in others (DKD Resistors). We
hypothesized that patients with DKD would exhibit higher copeptin concentrations
vs. DKD Resistors., Participants with type 1 diabetes (n?=?62, duration
=50?years) were stratified into 42 DKD Resistors and 20 with DKD (eGFR
=60?mL/min/1.73m2 or =30?mg/day urine albumin), and age/sex-matched controls
(HC, n?=?74) were included. Glomerular filtration rate (GFR) and effective renal
plasma flow (ERPF) were calculated by inulin and p-aminohippurate clearance
before and after angiotensin II (ang II) infusion. Renal vascular resistance
(RVR) was calculated as mean arterial pressure/renal blood flow. Plasma
copeptin, renin, aldosterone, neutrophil gelatinase-associated lipocalin (NGAL),
and urea concentrations were measured, along with 24-h urine volume., DKD
resistors had lower copeptin (95% CI: 4.0 [3.4-4.8] pmol/l) compared to DKD (5.8
[4.5-7.6] pmol/l, p?=?0.02) and HC (4.8 [4.1-5.5] pmol/l, p?=?0.01) adjusting
for age, sex and HbA1c. In type 1 diabetes, higher copeptin correlated with
lower GFR (r: -0.32, p?=?0.01) and higher renin concentration (r: 0.40,
p?=?0.002) after multivariable adjustments. These relationships were not evident
in HC. Copeptin inversely associated with RVR change following exogenous ang II
only in participants with type 1 diabetes (脽?卤?SE: -6.9?卤?3.4, p?=?0.04)., In
longstanding type 1 diabetes, copeptin was associated with intrarenal
renin-angiotensin-aldosterone system (RAAS) activation and renal hemodynamic
function, suggesting interplay between AVP and RAAS in DKD pathogenesis.
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