Endocrine Abstracts

Kidneys reserve mechanisms are of great scientific and practical interest.

In 56 patients with diabetes mellitus two types and diabetic kidney disease (DKD), 24 men (42.9%) and 32 women (57.1%) aged from 38 to 81 years (61.3±2.65) had been estimated the renal functional reserve (RFR) with water-salt load of 0.5% NaCl in the amount of 0.5% body mass to determine the reduction of nephron’s amount using the level of glomerular filtration rate (GFR) before loading (with formula of GFR – EPI) and after loading (with clearance of creatinine).

In patients with DKD 1 and 2 stage after water–salt load of 435±37.1 and 465±49.9 ml, urine output was 249±55.5 ml and 220±102 ml with albumin excretion of 7.96±4.87 and 6.54±2.54 mg/mmol. The GFR level increased from 95.1±1.88 to 226±60.2 ml/min and from 72.4±4.47 to 173±47.7 ml/min, the renal function reserve averaged 226±60.2 and 137±61.3 ml/min, accordingly. In patients with CKD 3a and 3b stage after loading of 432±58.8 ml, the urine output was 179±48.4 ml with albumin excretion of 16.63±9.98 mg/mmol. GFR level increased from 55.7±2.49 to 176±36.3 ml/min and renal function reserve averaged 216±59.3 ml/min.

In the renal function study were found that in 92.8% of patients with DKD 1 stage, in 50% of patients with DKD 2 stage and in 46.4% patients with DKD 3 stage despite markers of kidney damage like albuminuria or GFR bellow 60 ml/min, kidneys were able to increase the glomerular filtration rate to the level of standards and there was no reduction of the amount of functioning nephrons.