Evolution of Renal Hyperfiltration and Arterial Stiffness From Adolescence Into Early Adulthood in Type 1 Diabetes

Original Research

¹Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
²Division of Pediatric Endocrinology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada

Diabetes Care 2011 Aug; 34(8): 1821-1826. https://doi.org/10.2337/dc11-0167

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Figure 1
Changes in GFR (A), FF (B), RVR (C), and radial augmentation index (D) are shown in hyperfiltering and normofiltering participants (mean ± SD). *P ≤ 0.030 for the within-group change in parameter vs. baseline. †P ≤ 0.033 for the change in the hemodynamic parameter in hyperfiltering vs. normofiltering subjects.

Table 1

Baseline characteristics by GFR at baseline and at follow-up

	Hyperfiltering group (n = 10)		Normofiltering group (n = 8)
Parameter	Baseline	Follow-up	Baseline	Follow-up
Male	70	N/A	63	N/A
Age (years)	16.3 ± 3.2	23.4 ± 2.7	17.4 ± 3.3	24.0 ± 1.9
Weight (kg)	74.2 ± 12.8	75.7 ± 10.1	71.4 ± 13.7	69.1 ± 13.6
Height (cm)	170.6 ± 5.9	174.9 ± 8.7	162.4 ± 3.7	165.0 ± 9.3
BMI (kg/m²)	24.3 ± 2.6	24.8 ± 3.1	26.4 ± 2.6	25.4 ± 3.8
HbA_1c (%)	7.89 ± 0.70	9.2 ± 1.2	7.86 ± 0.69	8.6 ± 1.59
24-h albumin excretion (mg/min)	4.4 ± 2.8	5.0 ± 2.8	5.2 ± 2.3	3.1 ± 2.4
Sodium (mmoL/day)	186 ± 35	191 ± 36	219 ± 56	214 ± 55
Protein (g/kg/day)	0.90 ± 0.36	0.99 ± 0.43	0.94 ± 0.45	0.97 ± 0.39
Plasma insulin (pmol/L)	41 ± 24	32 ± 27	46 ± 28	29 ± 20
Total insulin dose (units/kg/day)	1.2 ± 0.4	0.9 ± 0.4	1.1 ± 0.2	0.7 ± 0.1
Estrogen (pmol/L)	127 ± 60	267 ± 99	147 ± 113	159 ± 37

Table 2

Mean systemic and renal hemodynamic function in hyperfiltering and normofiltering participants

	Hyperfilterers (n = 10)		Normofilterers (n = 8)
Parameter	Baseline	Follow-up	Baseline	Follow-up
Peripheral vascular parameters
Heart rate (bpm)	69 ± 8	65 ± 10	72 ± 11	71 ± 9
Blood pressure (mmHg)
Systolic	112 ± 8	112 ± 7	114 ± 12	112 ± 12
Diastolic	61 ± 3	61 ± 4	64 ± 4	62 ± 5
Mean arterial pressure (mmHg)	78 ± 4	80 ± 4	78 ± 7	79 ± 6
Augmentation index (%)	1.2 ± 11.7	−11.0 ± 7.8^*	14.3 ± 14.0	2.5 ± 14.6^*
Renal hemodynamic function
ERPF (mL/min/1.73 m²)	713 ± 120	654 ± 111	664 ± 114	689 ± 124
GFR (mL/min/1.73 m²)	171 ± 20	120 ± 15^*^†	120 ± 6^‡	125 ± 13
FF	0.24 ± 0.06	0.18 ± 0.03^*^†	0.18 ± 0.03^‡	0.19 ± 0.03
RBF (mL/min/1.73 m²)	1,145 ± 86	1,063 ± 200	1,073 ± 159	1,072 ± 191
RVR (mmHg/L/min)	0.0678 ± 0.0135	0.0783 ± 0.0121^*	0.0745 ± 0.0118	0.0780 ± 0.0159
Circulating RAS mediators
Plasma renin activity (ng/L/s)	0.40 ± 0.31	0.24 ± 0.30	0.35 ± 0.40	0.63 ± 0.40
Angiotensin II (pmol/L)	4.3 ± 2.0	2.7 ± 2.5	2.8 ± 2.7	1.5 ± 2.6
Aldosterone (pmol/L)	155 ± 122	44 ± 43^*	126 ± 50	34 ± 23^*

Data are shown as the mean ± SD.
↵*P ≤ 0.030 for the within-group change in parameter vs. baseline.
↵†P ≤ 0.033 for the change in hemodynamic parameter in hyperfiltering vs. normofiltering subjects.
↵‡P ≤ 0.010 for the between-group difference in baseline parameter in normofiltering vs. hyperfiltering subjects.