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  • 1
    ISSN: 1432-0428
    Keywords: Arterial blood pressure ; antihypertensive treatment ; diabetic retinopathy ; diabetic nephropathy ; Type 1 (insulin-dependent) diabetes ; vitreous fluorometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of antihypertensive treatment on blood-retinal barrier leakage of fluorescein in background retinopathy was studied in nine hypertensive Type 1 (insulin-dependent) diabetic patients suffering from nephropathy. The patients were investigated before and after 7 (3 to 13) months of treatment with captopril (n=8; 25 to 100 mg daily) and a diuretic, either frusemide (n=4; 80 to 200 mg daily) or bendrofluazide (n=2; 2.5 mg daily). Retinal function was assessed by fundus photography, fluorescein angiography, vitreous fluorometry, and renal function by glomerular filtration rate, and albuminuria. The antihypertensive treatment induced a significant reduction (p〈0.05) in: blood pressure from 152/97±14/8 mmHg to 134/82±11/6 mmHg; blood-retinal barrier leakage of fluorescein from 2.4 ±1.1 to 1.4±0.5·10−7 cm/second; albuminuria from 1391 (range: 168–4852) μg/min to 793 (range: 35–2081) ug/min. Glomerular filtration rate declined from 88±15 to 78±23 ml·min−1·1.73 m2 (0.05〈p〈0.10). The metabolic control of the patients as reflected by their blood glucose and HbA1c levels remained stable during the study. Our study suggests that systemic blood pressure elevation contributes to the abnormal blood-retinal barrier permeability to fluorescein characteristically found in diabetic background retinopathy and that this abnormality can be reversed during antihypertensive treatment.
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  • 2
    ISSN: 1432-0428
    Keywords: Arterial blood pressure ; children ; glycosylated haemoglobin ; retinopathy ; Type 1 diabetes ; urinary albumin excretion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The prevalence of microalbuminuria was determined in children aged 7 to 18 years with Type 1 (insulin-dependent) diabetes of more than 2 years' duration. All patients (n =102) attending 2 diabetes clinics were asked to collect 2 overnight timed urine samples for albumin analysis by radioimmunoassay. Complete urine collection was obtained in 97 patients (95%). Overnight urinary albumin excretion rates were also measured in 36 healthy children matched for age and sex. Nineteen of the 97 patients (20%) had microalbuminuria, i. e. overnight urinary albumin excretion rates above the upper normal level (14 μg/min) in both urine collections. Microalbuminuria was only demonstrated in patients aged ≥ 15 years, prevalence 37% (19/52 patients). Arterial blood pressure was elevated, mean 122/84±11/9mmHg, in the microalbuminuric group (19 patients) compared to the age-matched normoalbuminuric diabetic group (33 patients), mean 117/74±10/10 mm Hg,p 〈 0.001. The prevalence of simplex retinopathy was identical in these two groups, i. e. 25%. Glycosylated haemoglobin was slightly higher in the microalbuminuric patients,p 〈 0.10. Our cross-sectional study reveals a high prevalence (37%) of persistent microalbuminuria, a stage highly predictive of later development of diabetic nephropathy, in Type 1 diabetic children aged ≥ 15 years.
    Type of Medium: Electronic Resource
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