Low plasma aldosterone despite normal plasma renin activity in uncomplicated type 1 diabetes mellitus: effects of RAAS stimulation

Luik, PT; Kerstens, Michael; Hoogenberg, Klaas; Navis, Gerarda; Dullaart, Robin

doi:10.1046/j.1365-2362.2003.01215.x

Cited by 15 publications

(13 citation statements)

References 44 publications

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“…Another study also showed increased components of the reninangiotensin-aldosterone system in patients with diabetes mellitus type 1, namely increased plasma aldosterone levels ( Hollenberg et al, 2004 ). Other human studies indicate reduced aldosterone levels in type 1 diabetes mellitus ( Luik et al, 2003 ;Cronin et al, 1995 ). In a model of type 1 diabetes, the streptozotocin-diabetic rat, cardiac fi brosis was enhanced and could be attenuated by treatment with spironolactone ( Miric et al, 2001 ), suggesting an important role of aldosterone in diabetes mellitus.…”

Section: Discussionmentioning

confidence: 93%

Increased Aldosterone Levels in a Model of Type 2 Diabetes Mellitus

Fredersdorf¹,

Endemann²,

Luchner³

et al. 2008

Exp Clin Endocrinol Diabetes

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Section: Discussionmentioning

confidence: 93%

Increased Aldosterone Levels in a Model of Type 2 Diabetes Mellitus

Fredersdorf¹,

Endemann²,

Luchner³

et al. 2008

Exp Clin Endocrinol Diabetes

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“…The therapy for diabetes did not affect the change in PRA and ARR. N. K. Hollenberg and colleagues, in their work indicate that patients with diabetes mellitus show an increase in PRA, angiotensin II concentration and plasma aldosterone concentration (41). In the opinion of other authors, most patients with type 2 diabetes have normal circulating levels of plasma aldosterone.…”

Section: Discussionmentioning

confidence: 95%

“…N.K. Hollenberg i saradnici u svom radu iznose da pacijenti sa dijabetes melitusom pokazuju porast PRA, koncentracije angiotenzina II i plazma koncentracije aldosterona (41). Prema mišljenju drugih autora, ve ina pacijenata sa tipom 2 dijabetesa ima normalne cirkulišu e nivoe plazma aldosterona.…”

Section: Diskusijaunclassified

Influence of antihypertensive therapy, sodium intake and the concentration of potassium in plasma on concentration of aldosterone and plasma renin activity

Lalic¹

2013

Med gl Ins stit Zlatibor

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APSTRAKT: Uvod: Primarni aldosteronizam (PA) predstavlja grupu poreme aja koja se odlikuje neadekvatnom i nesupresibilnom produkcijom aldosterona. Prevalenca PA je rastu a u hipertenzivnoj populaciji. Zlatni standard za skrining PA, odre ivanje odnosa (ARR) aldosterona i plazma reninske aktivnosti (PRA) posturalno, pod uticajem je brojnih endogenih i egzogenih faktora. Testiranje u optimalnim uslovima nije uvek mogu e. Cilj rada:Utvrditi kakav je uticaj antihipertenzivnih lekova i koncentracije kalijuma i natrijuma u krvi i urinu na vrednosti aldosterona i plazma reninsku aktivnost.Metod rada: U retrospektivnoj studiji analizirana je medicinska dokumentacija pacijenata primljenih na Odeljenje za bolesti štitaste žlezde u periodu [2009][2010][2011]. godine sa pove anim rizikom za primarni aldosteronizam. Kod svih pacijenata analizirani su telesna masa i visina, koncentracije natrijuma i kalijuma u serumu i urinu, koncentracije aldosterona u plazmi i PRA, podaci o lekovima u terapiji i pridruženim bolestima. Od statisti kih metoda koriš eni su metodi deskriptivne statistike, Studentov T test i jednostruka linearna povezanost.Rezultati: Od 137 pacijenata bilo je više pacijenata sa rezistentnom hipertenzijom (53,28%) nego sa tumorima nadbubrega (46,72%). Najviše pacijenata bilo je na terapiji kalcijumskim antagonistima. Terapija alfa adrenergi kim i kalcijumskim antagonistima ne uti e na ARR. Blokatori beta adrenergi kih receptora i ACE inhibitori mogu da uti u, a diuretici i vazodilatatori sigurno uti u. Dijabetes melitus može da nosi ve i rizik od lažno negativnih rezultata. Natriureza je zna ajno povezana sa plazma aldosteronom i kalijumom u serumu. Plazma aldosteron i PRA zna ajno su povezani sa koncentracijama elektrolita u urinu. 45UTICAJ ANTIHIPERTENZIVNE TERAPIJE, UNOSA NATRIJUMA I KONCENTRACIJE KALIJUMA... Zaklju ak:Pove ana prevalenca primarnog aldosteronizma name e potrebu za preciznijom i boljom dijagnostikom.Klju ne re i: aldosteron, PRA, lekovi, natrijum, kalijum UVODPrimarni aldosteronizam (PA) predstavlja grupu poreme aja u kojima je produkcija aldosterona neodgovaraju e velika, relativno autonomna i nesupresibilna nakon optere enja natrijumom (2). Najvažniji poreme aji su aldosteron produkuju i adenom (APA), unilateralna ili bilateralna hiperplazija nadbubrega (UAH ili BAH, IHA), glukokortikoidima korektibilan aldosteronizam (GKA) i aldosteron produkuju i adrenalni karcinom (1, 2). Od kada je Kon (Conn) 1954. godine prvi opisao klini ki sindrom hipertenzije, hipokalemije i metaboli ke alkaloze kao rezultat autonomne produkcije aldosterona iz adenoma nadbubrega, brojna istraživanja pokušavaju da utvrde prevalencu ovog poreme aja (2). Primarni aldosteronizam je ranije smatran retkim i dijagnoza prakti no nije bila mogu a bez hipokalemije. Danas više od polovine pacijenata sa PA ima normalan kalijum (1). Novija istraživanja ukazuju na sve ve u prevalencu -više od 10% hipertenzivnih pacijenata, a od 5 do 20% u slu aju tip 2 dijabetesa i rezistentne hipertenzije (3). Primarni aldosteronizam je u osnovi 3...

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“…After completion of the baseline clearance period of 50 min, AngII (Clinalfa AG, Switzerland) was administered intravenously in a dosage of 8 g/kg per min for 60 min. This dosage is known to cause a moderate systemic and renal hemodynamic pressure response, as described previously (23). This was followed by a 20-min recovery period.…”

Section: Protocolmentioning

confidence: 99%

Proteinuria-Lowering Effect of Heparin Therapy in Diabetic Nephropathy without Affecting the Renin-Angiotensin-Aldosterone System

Benck

Haeckel

Clorius

et al. 2007

Clinical Journal of the American Society of Nephrology

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Angiotensin-converting enzyme inhibitors and angiotensin II (AngII) type 1 receptor blockers lower proteinuria and preserve renal function in diabetic nephropathy (DN). The antiproteinuric effects are greater than their blood pressure reduction, involving the sieving properties of the glomerular filter. In DN, glomerular staining for heparan sulfate proteoglycans is decreased. AngII inhibits heparan sulfate synthesis. Also, heparins modulate AngII signaling in glomerular cells, inhibiting aldosterone synthesis and lowering proteinuria in DN. Is the antiproteinuric effect of heparins due to its interference with the renin-angiotensin-aldosterone system? Ten volunteers each with DN and glomerulonephritis and control subjects were examined before and after low-dosage enoxaparin. Renal hemodynamics were determined with 99m Tc-DTPA and 131 Ihippurate clearance. Glomerular filtration rate (GFR), effective renal plasma flow, mean arterial pressure, and heart rate were measured at baseline and during AngII infusion before and after enoxaparin while on normal salt and salt restriction. Enoxaparin did not lower aldosterone levels. GFR remained stable in all groups. AngII caused a significant decrease in effective renal plasma flow, whereas mean arterial pressure and heart rate increased significantly. Enoxaparin did not influence the AngII-induced changes of renal hemodynamics during normal salt intake or salt restriction. All groups showed identical responses to AngII before and after enoxaparin. In patients with diabetes, enoxaparin caused a significant decrease in proteinuria. It is concluded that the antiproteinuric effect of heparins in DN cannot be explained via interaction with the renin-angiotensin-aldosterone system. The absence of hemodynamic changes combined with reduced proteinuria point to intrinsic alterations in the glomerular filter. The effects were seen only in DN, not in glomerulonephritis.

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Low plasma aldosterone despite normal plasma renin activity in uncomplicated type 1 diabetes mellitus: effects of RAAS stimulation

Cited by 15 publications

References 44 publications

Increased Aldosterone Levels in a Model of Type 2 Diabetes Mellitus

Increased Aldosterone Levels in a Model of Type 2 Diabetes Mellitus

Influence of antihypertensive therapy, sodium intake and the concentration of potassium in plasma on concentration of aldosterone and plasma renin activity

Proteinuria-Lowering Effect of Heparin Therapy in Diabetic Nephropathy without Affecting the Renin-Angiotensin-Aldosterone System

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