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Podocyte number in normotensive type 1 diabetic patients with albuminuria

Lookup NU author(s): Dr Kathryn White, Professor Rudy Bilous, Professor Sally Marshall

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Abstract

We estimated glomerular cell number in 50 normotensive type 1 diabetic patients with raised albumin excretion rate (AER) and investigated any change after 3 years in a subgroup of 16 placebo-treated patients. Biopsies from 10 normal kidney donors were used as controls. Mesangial and endothelial cell number was increased in the 50 diabetic patients at the start of the study compared with control subjects. There was no difference in podocyte number. Glomerular volume was increased in diabetic patients, but surface area of glomerular basement membrane (GBM) underlying the podocytes did not differ between groups. AER correlated positively with mesangial cell number in microalbuminuric patients (r = 0.44, P = 0.012) and negatively with podocyte number in proteinuric patients (r = -0.48, P = 0.040). In the 16 placebo-treated patients, glomerular volume increased after 3 years owing to matrix accumulation and increased GBM surface area. Although overall cell number did not differ significantly from baseline, the decrease in podocyte number during follow-up correlated with AER at follow-up (r = -0.72, P = 0.002). In conclusion, crosssectional analysis of podocyte number in type 1 diabetic patients with raised AER but normal blood pressure shows no significant reduction compared with nondiabetic control subjects. Longitudinal data provide evidence for an association between podocyte loss and AER, but whether cellular changes are a response to, a cause of, or concomitant with the progression of nephropathy remains uncertain.


Publication metadata

Author(s): White KE, Bilous RW, Marshall SM, El Nahas M, Remuzzl G, Piras G, De Cosmo S, Vlberti G

Publication type: Article

Publication status: Published

Journal: Diabetes

Year: 2002

Volume: 51

Issue: 10

Pages: 3083-3089

Print publication date: 01/10/2002

ISSN (print): 0012-1797

ISSN (electronic): 1939-327X

Publisher: American Diabetes Association

URL: http://dx.doi.org/10.2337/diabetes.51.10.3083

DOI: 10.2337/diabetes.51.10.3083

PubMed id: 12351451


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