Abnormal Glucose Tolerance in Patients with Chronic Glomerulonephritis Without Renal Failure

Abstract

An oral glucose tolerance test and an assay of insulin receptor activity were performed in patients with chronic glomerulonephritis (CGN) to elucidate the aberration of glucose metabolism in such patients. Ninety of 123 patients with CGN without renal failure showed abnormal glucose tolerance, including 72.6% with IgA nephropathy, 81% with benign recurrent hematuria, 87% with chronic proliferative glomerulonephritis, 100% with membranoproliferative glomerulonephritis, and 80.0% with membranous nephropathy. Insulin responses in CGN patients during oral glucose tolerance tests showed lower levels of basal insulin and significantly higher levels after 90, 120, and 180 min compared with those of normal controls. The binding of radiolabeled insulin to blood mononuclear cells in 22 CGN patients with abnormal glucose tolerance was significantly (P = 0.0023) decreased in comparison with 5 normal controls. However, plasma obtained from such patients showed no significant (P = 0.4761) inhibition of the binding of insulin to normal mononuclear cells. It was concluded that glucose tolerance capacity was impaired in 80.4% of patients with CGN without renal failure. Such impairment of glucose metabolism might be due to decreased activity of insulin receptors on cells in CGN patients.

Normal Glucose Tolerance in Young Patients with Nonazotemic Chronic Glomerulonephritis

“…Our findings of normal oral glucose tolerance in 9 subjects with nonazotemic nephritis, most notably IgA nephropathy, contrast with those of Kaneshige et al [2] who found impaired glucose tolerance in 45 of 62 cases of IgA nephropathy and in 17 of 21 cases o f 'benign recur rent hematuria". I n addition to genetic and dietary factors which distinguish our population from the Japanese pa- …”

“…The association of glucose intolerance with chronic renal failure is well known [1], Kaneshige et al [2] re ported that nonazotemic patients with chronic glomeru lonephritis also have a high prevalence of abnormal glucose tolerance. In order to study the mechanisms by which chronic glomerular disease without uremia can affect glucose homeostasis, we attempted to confirm the high prevalence of glucose intolerance in 9 patients (4 males and 5 females) with IgA nephritis (Berger's dis ease) and/or familial nephritis.…”

Insulin resistance and the progression of IgA glomerulonephritis

“…glucose tolerance test or clamp were not feasible in the present study design, we chose to use the fasting insulin values and HOMA-IR to assess insulin resistance. Most of the earlier studies on insulin resistance in mild to moderate renal insufficiency have included patients with a variety of kidney diseases, and the number of IgAGN patients in many of those reports has been rather low [6][7][8][9][10]15]. None of the previous studies have provided several years of follow-up information concerning the progression of IgAGN in relation to insulin levels.…”

“…Moreover, insulin resistance is an independent predictor of cardiovascular mortality in the ESRD population [5]. Over the past decade, a body of evidence has accumulated showing the existence of insulin-resistance also in mild to moderate CRI, or even before the impairment of kidney function [6][7][8][9][10]. Two population studies have reported a significant relationship between chronic kidney disease and insulin resistance [11,12].…”

Prognostic prediction of idiopathic membranous nephropathy using interpretable machine learning

“…FPG reflects islet β-cell function and generally indicates the basic insulin secretion function. Patients with CKD showed varying degrees of impaired glucose tolerance [ 42 ]. In a cohort study of 1313 IMN patients, Cox regression showed that urinary glucose and baseline SCr were risk factors for a 50% reduction in eGFR [ 43 ].…”