Transcapillary Escape Rate of Albumin in Type II Diabetic Patients: The relationship with microalbuminuria and hypertension

Nannipieri, Monica; Penno, Giuseppe; Rizzo, Loredana; Pucci, Laura; Bandinelli, S.; Mattei, Paola; Taddei, Stefano; Salvetti, Antonio; Navalesi, Renzo

doi:10.2337/diacare.20.6.1019

Cited by 16 publications

(6 citation statements)

References 6 publications

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“…Furthermore, sodium retention and excessive activation of the renin-angiotensin-aldosterone system have been linked to uncontrolled BP in individuals with CKD (20,21). Also, albuminuria is thought to be preceded by systemic endothelial dysfunction (22). Although endothelial dysfunction is associated with incident hypertension, the presence of uncontrolled BP has also been associated with worsening endothelial function (23,24).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Apparent Treatment-Resistant Hypertension among Individuals with CKD

Tanner

Calhoun²,

Bell³

et al. 2013

Clinical Journal of the American Society of Nephrology

143

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SummaryBackground and objectives Apparent treatment-resistant hypertension is defined as systolic/diastolic BP$140/ 90 mmHg with concurrent use of three or more antihypertensive medication classes or use of four or more antihypertensive medication classes regardless of BP level.Design, setting, participants, & measurements The prevalence of apparent treatment-resistant hypertension among Reasons for Geographic and Racial Differences in Stroke study participants treated for hypertension (n=10,700) was determined by level of estimated GFR and albumin-to-creatinine ratio, and correlates of apparent treatment-resistant hypertension among those participants with CKD were evaluated. CKD was defined as an albumin-to-creatinine ratio$30 mg/g or estimated GFR,60 ml/min per 1.73 m 2 .Results The prevalence of apparent treatment-resistant hypertension was 15.8%, 24.9%, and 33.4% for those participants with estimated GFR$60, 45-59, and ,45 ml/min per 1.73 m 2 , respectively, and 12.1%, 20.8%, 27.7%, and 48.3% for albumin-to-creatinine ratio,10, 10-29, 30-299, and $300 mg/g, respectively. The multivariableadjusted prevalence ratios (95% confidence intervals) for apparent treatment-resistant hypertension were 1.25 (1.11 to 1.41) and 1.20 (1.04 to 1.37) for estimated GFR levels of 45-59 and ,45 ml/min per 1.73 m 2 , respectively, versus $60 ml/min per 1.73 m 2 and 1.54 (1.39 to 1.71), 1.76 (1.57 to 1.97), and 2.44 (2.12 to 2.81) for albumin-tocreatinine ratio levels of 10-29, 30-299, and $300 mg/g, respectively, versus albumin-to-creatinine ratio,10 mg/g. After multivariable adjustment, men, black race, larger waist circumference, diabetes, history of myocardial infarction or stroke, statin use, and lower estimated GFR and higher albumin-to-creatinine ratio levels were associated with apparent treatment-resistant hypertension among individuals with CKD.Conclusions This study highlights the high prevalence of apparent treatment-resistant hypertension among individuals with CKD.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Apparent Treatment-Resistant Hypertension among Individuals with CKD

Tanner

Calhoun²,

Bell³

et al. 2013

Clinical Journal of the American Society of Nephrology

143

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“…During diabetes, basement membrane proteoglycan content is markedly decreased in several tissues such as the renal glomerulus [ 35, 36], where the loss of charge selective matrix is reflected by an increase in AER and in GAG excretions. In microalbuminuric hypertensive diabetic patients the albumin transcapillary escape from the general vascular bed is increased [ 37], suggesting a widespread basal membrane alteration. The proteoglycan reduction at the glomerular level might be responsible for an increase in basement membrane formation from mesangial cells, resulting in microthrombus formation, hyper‐responsiveness to growth factors and enhanced secretion of vasoconstrictor molecules [ 38].…”

Section: Discussionmentioning

confidence: 99%

Additive effects of Simvastatin beyond its effects on LDL cholesterol in hypertensive type 2 diabetic patients

Tonolo¹,

Melis²,

Formato

et al. 2000

Eur J Clin Investigation

129

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“…(11)(12)(13)(14)(15)(16)(17) While studies which started sampling 10 minutes after injection found a lower TER alb of approximately 5.5%/h. (2,8,(18)(19)(20)(21)(22) These differences in TER alb were not related to differences in patient population, but are in line with the multi-exponential kinetics of rHSA.…”

Section: Introductionmentioning

confidence: 55%

Transcapillary escape rate of 125I-albumin in relation to timing of blood sampling: the need for standardization.

Chahid

Rorije

Boujoufi

et al. 2021

Preprint

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Background Increased vascular permeability is an early sign of vascular damage and can be measured with the transcapillary escape rate of albumin (TERalb). Although TERalb has a multi-exponential kinetic model, most published TERalb data are based on mono-exponential kinetic models with variation in blood sampling schemes. Aim of this posthoc study was to evaluate the influence of variation in blood sampling schemes and the impact of mono- or bi-exponential analyses on the calculation of TERalb. Study participants were part of a cross-over intervention study protocol, investigating effects of sodium loading on blood pressure, endothelial surface layer and microcirculation. Multiple blood samples were drawn between 3 and 60 minutes after injection of radioactive iodide labeled human serum albumin (rHSA). Results In total 27 male participants with 54 measurements were included. For all participants the maximum serum radioactivity was reached within 20 minutes, while 85% of the participants had their maximum serum activity within 10 min. The TERalb calculated with the subsequently chosen T20 – 60 min reference scheme (6.19 ± 0.49%/h) was significantly lower compared to the TERalb of the T3 – 60 min, T5 – 60 min, and Tmax – 60 min schemes. There was no significant difference between the T20 – 60 min reference scheme and the T10 – 60 min and T15 – 60 min schemes. Bi-exponential kinetic modeling did not result in significant different observations compared to the mono-exponential kinetic analysis.Conclusions As there is variation in the timing of the maximum serum radioactivity of rHSA, blood sampling schemes starting before 10 minutes after administration of rHSA will result in a significant overestimation of TERalb. In addition, variation in kinetic modeling did not result in significant changes in TERalb. Therefore, we emphasize the need to standardize TERalb and for practical and logistical reasons advocate the use of a mono-exponential model with blood sampling starting 20 minutes after rHSA administration.

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Transcapillary Escape Rate of Albumin in Type II Diabetic Patients: The relationship with microalbuminuria and hypertension

Cited by 16 publications

References 6 publications

Prevalence of Apparent Treatment-Resistant Hypertension among Individuals with CKD

Prevalence of Apparent Treatment-Resistant Hypertension among Individuals with CKD

Additive effects of Simvastatin beyond its effects on LDL cholesterol in hypertensive type 2 diabetic patients

Transcapillary escape rate of 125I-albumin in relation to timing of blood sampling: the need for standardization.

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