Glomerular filtration rate in early diabetes: ongoing discussions of causes and mechanisms

J Nephrol. 2011 Sep-Oct;24(5):537-40. doi: 10.5301/jn.5000009.

Abstract

Glomerular hyperfiltration (>140 ml/min per 1.73 m2 body surface area) is found in early diabetes and is associated with a poor prognosis with respect to the development of diabetic kidney disease. This review addresses recent investigations and discussions of the following hypotheses behind diabetic hyperfiltration: Increased proximal tubular volume reabsorption results in a pressure drop in Bowman's capsule which increases glomerular filtration rate (GFR). Proximal tubular hyperreabsorption induces an increase in GFR mediated by tubuloglomerular feedback. Dietary NaCl restriction results in a paradoxically increased GFR and increased urine volume in diabetic animals.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Diabetic Nephropathies / etiology*
  • Diabetic Nephropathies / metabolism
  • Diabetic Nephropathies / physiopathology
  • Disease Progression
  • Glomerular Filtration Rate*
  • Humans
  • Kidney / metabolism
  • Kidney / physiopathology*
  • Prognosis
  • Risk Factors
  • Sodium Chloride, Dietary / metabolism
  • Time Factors

Substances

  • Sodium Chloride, Dietary