Early changes in pulmonary function and intrarenal haemodynamics and the correlation between these sets of parameters in patients with T2DM

Abstract

PurposeThe main objectives of this study were to assess the early changes in pulmonary function and intrarenal haemodynamics and to determine the correlation between pulmonary function and intrarenal haemodynamics in patients with type 2 diabetes mellitus (T2DM).Methods96 patients with T2DM (diabetes group) without diabetes kidney disease (DKD) and 33 healthy subjects (control group) were enrolled in studies intended to assess the early changes in pulmonary function and intrarenal haemodynamics associated with diabetes, as well as to determine the correlation between pulmonary function and intrarenal haemodynamics.ResultsPulmonary functional parameters were negatively correlated with HbA1c levels and diabetes duration (P< 0.05). Moreover, renal functional parameters were positively correlated with HbA1c levels and diabetes duration (P<0.05). Additionally, pulmonary functional parameters were negatively correlated with renal functional parameters (P<0.05). Multiple linear regression analysis of the relationship between pulmonary functional parameters and the bilateral kidney arterial resistivity index (RI) showed that all the pulmonary functional parameters were significantly correlated with the arterial RI (P< 0.05).ConclusionsPatients displayed changes in pulmonary function and intrarenal haemodynamics during the preclinical stages of DKD. Regulating glycaemia may improve intrarenal haemodynamics in the bilateral interlobular renal arteries. Moreover, during the preclinical stages of DKD, the right kidney RI is a effective predictor of early changes in pulmonary function in adult T2DM patients.Trial registrationClinicalTrials.gov (NCT02798198); registered 8 June 2016.

Diabetes and Renal Complications: An Overview on Pathophysiology, Biomarkers and Therapeutic Interventions

“…Diabetes-mediated chronic hyperglycaemia, which causes an increase in the osmolarity within glomerular capillaries leads to an increase in glomerular pressure and dilation of afferent arterioles, causing glomerular hyperfiltration, resulting in increased glomerular filtration rate [8,9]. These haemodynamic alterations also initiate and activate several vasoactive systems within the kidneys that further contribute to the progression of DKD [10,11]. These include the activation of the renin-angiotensin-aldosterone system (RAAS), protein kinase C (PKC), polyol and advanced glycation end product (AGE) dependent pathways as well as the more recently explored pro-oxidant enzyme NADPH oxidases [12][13][14][15][16].…”