Tubular transport in kidneys of the patients with essential hypertension in combination with diabetes mellitus type II

Abstract

It has been studied the segmental tubular sodium reabsorbtion in 32 patients with essential hypertension combined with diabetes mellitus type II (main group), in 30 patients with essential hypertension, in 30 patients with diabetes mellitus type II (I и II comparative groups) with microalbuminuria and in 30 healthy persons on the background of oral salt loading with 172.4 mmol of sodium and of supported water diuresis with taking of 20 ml of distilled water on kg of body weight. After salt loading in patients of main group with essential hypertension combined with diabetes mellitus type II sodium excretion in-creased more than by 2 times (p<0.05) in the first 3 hours, then in consenquent 3 hours significantly falled and was lower than in healthy persons and in patients of both comparative groups. In patients with essential hypertension combined with diabetes mellitus type II a functional reserve of sodium tubular transport significantly decreased and fast depleted during excretion of salt loading. In healthy persons and in patients of both comparative groups kidneys excreted more than 65% of loading sodium, in patients of main group – only 52.2±2.3% (p<0.05). In patients with essential hypertension combined with diabetes mellitus type II excreted renal function was disturbed in greater degree than in patients with essential hypertension and than in patients with diabetes mellitus type greater in patients with essential hypertension in patients with diabetes mellitus type II ability short-term too. The excretion of surplus sodium in patients with essential hypertension in greater degree was determined by hydrostatic factor, in patients with diabetes mellitus type II it was determined in greater degree by volumetric factor, in patients with essential hypertension combined with diabetes mellitus type II it was mainly determined by volumetric factor. Thus, excretion of surplus sodium in patients with essential hypertension combined with diabetes mellitus type II was mainly determined by mechanisms which were caused by diabetes mellitus type II and in less degree by essential hypertension. Tubular-glomerular balans index in healthy persons was 160 mmol/mm Hg, in patients with diabetes mellitus type II – 233 mmol/mm Hg, in patients with essential hypertension (30 mmol/mm Hg) and especially in patients with essential hypertension combined with diabetes mellitus type II (9 mmol/mm Hg) it was significantly disturbed. Proximal sodium reabsorbtion in patients of main group decreased by 1.0±0.4% (р>0.05) in other groups by 2.7-4.3%. Distal sodium reabsorbtion in patients of main group decreased by 7.6±0.5% (р<0.05) and by 5.7-6.1% in other groups. mellitus type