Key result
Continuous subcutaneous insulin infusion lowers GFR by ~13 ml/min vs. conventional insulin without altering kidney volume.
RCT (n=24)
Randomly allocated (1:1)
Glomerular filtration rate (GFR), renal plasma flow (RPF), kidney volume, and urinary albumin excretion rate were measured in 24 insulin-dependent diabetics, aged 29 +/- 7 years (mean +/- S.D.) of 8 +/- 4 years duration, randomly allocated to either continuous subcutaneous insulin infusion (CSII) (n = 12) or unchanged conventional insulin treatment (CIT) (n = 12). Glomerular filtration rate, renal plasma flow, and kidney volume were identical in the two groups at the start of the study, although significantly increased above normal values. During the 6 months CSII treatment a reduction of the GFR from 145 +/- 21 to 132 +/- 14 ml/min (2p = 2.4%) was seen, no change was observed in the CIT group while in both groups RPF and kidney volume remained unchanged. Urinary albumin excretion rate was normal or near normal in both groups and remained unchanged. Thus improved glycaemic control in insulin-dependent diabetics studied before the onset of microalbuminuria is associated with improved (reduced) GFR. Nephromegaly does not improve with 6 months CSII treatment. Whether it would improve with more prolonged treatment is uncertain.
No takes yet. Share an insight, caveat, or question.
Christensen et al. (1986) conducted an RCT in Insulin-dependent diabetes with nephromegaly and glomerular hyperfiltration (n=24). Continuous subcutaneous insulin infusion (CSII) vs. Unchanged conventional insulin treatment (CIT) was evaluated on Glomerular filtration rate (GFR, ml/min) (p=2p = 2.4%). Continuous subcutaneous insulin infusion for 6 months reduced GFR from 145 to 132 ml/min (2p=2.4%) vs no change with conventional insulin, without altering kidney volume.
Synapse has enriched 5 related papers. Consider them for comparative context: