RGD Reference Report - Normoalbuminuric type 1 diabetic patients with retinopathy have an impaired tubular response to desmopressin: its relationship with plasma endothelin-1.

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Normoalbuminuric type 1 diabetic patients with retinopathy have an impaired tubular response to desmopressin: its relationship with plasma endothelin-1.
Authors:	Hernandez, C Rodriguez, B Losada, E Corraliza, L Garcia-Ramirez, M Simo, R
Citation:	Hernandez C, etal., J Clin Endocrinol Metab. 2009 Jun;94(6):2060-5. Epub 2009 Mar 17.
RGD ID:	2313279
Pubmed:	PMID:19293263 (View Abstract at PubMed)
DOI:	DOI:10.1210/jc.2008-2784 (Journal Full-text)
OBJECTIVE: The aim of the study was to evaluate whether normoalbuminuric type 1 diabetic patients with diabetic retinopathy (DR) have an impaired tubular response to desmopressin (dDAVP, a synthetic analog of vasopressin) administration, and its relationship with plasma and urine endothelin-1 (ET-1) levels. DESIGN: This was an interventional case-control study. SETTING: The study was conducted at a referral center. PARTICIPANTS: Fifteen normoalbuminuric type 1 diabetic patients with DR were compared with 30 normoalbuminuric type 1 diabetic patients without DR. Both groups were matched by age, gender, body mass index, glycosylated hemoglobin, and the main laboratory markers of kidney function. INTERVENTION: After a 12-h period of water deprivation, dDAVP (0.3 microg/kg) was infused over 20 min. Urine was collected at baseline and 1, 2, and 3 h after dDAVP administration. ET-1 was assessed by ELISA. RESULTS: dDAVP induced a lower rise in urine osmolality in patients with DR (from 650 +/- 206 to 754 +/- 224 mosmol/kg; P = 0.02) than in diabetic patients without DR (from 714 +/- 194 to 905 +/- 163 mosmol/kg; P < 0.0001). In addition, fractional excretion of Na+ decreased in patients without DR (from 0.45 +/- 0.30 to 0.29 +/- 0.29%; P = 0.04) but not in the diabetic patients with DR (from 0.36 +/- 0.22 to 0.36 +/- 0.40%; P = 0.96). Plasma ET-1 levels were inversely correlated with the response of urinary osmolality after dDAVP administration (r = -0.62; P = 0.008). CONCLUSIONS: Normoalbuminuric type 1 diabetic patients with DR have impaired renal response to dDAVP that is related to plasma ET-1 levels. Further studies are required to elucidate whether this tubular resistance to dDAVP might favor dehydration in these patients.

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Term	Qualifier	Evidence	With	Reference	Notes	Source	Original Reference(s)
diabetic retinopathy		IEP		2313279	associated with Diabetes Mellitus more ...	RGD
diabetic retinopathy		ISO	EDN1 (Homo sapiens)	2313279; 2313279	associated with Diabetes Mellitus more ...	RGD

Objects Annotated

Genes (Rattus norvegicus)

Edn1 (endothelin 1)

Genes (Mus musculus)

Edn1 (endothelin 1)

Genes (Homo sapiens)

EDN1 (endothelin 1)

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Normoalbuminuric type 1 diabetic patients with retinopathy have an impaired tubular response to desmopressin: its relationship with plasma endothelin-1.