Tubular function and renal selectivity towards glycosyl-albumin in diabetic hyperosmolar states.

The type of proteinuria and renal selectivity of glycosyl albumin has been evaluated in seven diabetic patients at the onset of plasma hyperosmolar state and after complete fluid replacement. The main feature of all patients was a marked increase in urinary excretion of beta 2-microglobulin, which promptly returned to normal after the correction of the fluid disequilibrium. This indicates that a reversible tubular injury is the first symptom of the dehydration process in diabetic patients with plasma hyperosmolality.