Diabetes Care, Vol 11, Issue 10 846-849, Copyright © 1988 by American Diabetes Association

ARTICLES

Influence of antihypertensive therapy on development and progression of diabetic glomerulopathy

S Anderson and BM Brenner
Renal Division, Brigham and Women's Hospital, Boston, MA 02115.

Capillary hypertension is suggested to be the underlying cause of microvascular disease affecting the kidney, the retina, and other organs and tissues in diabetic patients and animals. Hyperglycemia causes an expansion of extracellular volume, which induces a vasodilatory response. Hemodynamic adaptation to vasodilation leads to an increase in intracapillary hydraulic pressure, which subsequently causes vascular damage. In experimental animals, restoration of capillary pressure to normal levels by ingestion of a low-protein diet or administration of an angiotensin I-converting enzyme inhibitor has been shown to prevent microvascular damage in the kidney, and dietary protein restriction limits injury in the retina as well. Atrial natriuretic peptide, which is secreted by atrial myocytes in response to volume expansion, may be involved in mediation of the hemodynamic adaptation (vasodilatory response) that results in diabetic microvascular disease.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				L. Poulsen Blood pressure and cardiac autonomic function in relation to risk factors and treatment perspectives in Type 1 diabetes Journal of Renin-Angiotensin-Aldosterone System, December 1, 2002; 3(4): 222 - 242. [Abstract] [PDF]

				V. L. L. Oliveira, E. D. Moreira, V. d. M. A. Farah, F. Consolim-Colombo, E. M. Krieger, and M. C. Irigoyen Cardiopulmonary Reflex Impairment in Experimental Diabetes in Rats Hypertension, October 1, 1999; 34(4): 813 - 817. [Abstract] [Full Text] [PDF]