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Sodium, renin, aldosterone, catecholamines, and blood pressure in diabetes mellitus
Open accessAbstract
Interrelations among plasma renin activity (PRA), aldosterone and cortisole levels, 0lood volume, exchangeable sodium, urinary catecholamines, and blood pressure were studied in 35 normal subjects and 60 age-matched non-azotemic patients with diabetes mellitus (60% with hypertension, 15% with orthostatic hypotension). Basal PRA, plasma aldosterone, cortisol, blood volume, plasma potassium, and urinary electrolytes were comparable in diabetic and normal subjects. Diabetic patients, however, had a 10% increase in body sodium (P less than 0.01), and 8% of them showed normal postural PRA responses and subnormal aldosterone responses; 22% had subnormal PRA and normal aldosterone responses, and 17% had subnormal responses of PRA and aldosterone. Non-PRA-related aldosterone responses could not be explained by ACTH or electrolytes. Orthostatic decreases in blood pressure correlated (P less than 0.01) with both catecholamine excretion and basal PRA. This suggests that in diabetes mellitus, body sodium is increased. Basal PRA and plasma aldosterone are usually normal, but their postural responses are frequently impaired. Absent aldosterone responses, despite normal PRA responsiveness, may reflect an adrenal abnormality or an ineffective form of renin. Marked postural aldosterone stimulation, unrelated to PRA, ACTH, or electrolytes, points to a potent unknown factor in aldosterone control. Low levels of free peripheral catecholamines and PRA may be complementary factors contributing to postural hypotension.
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“Specifically, diabetic nephropathy is characterized by increased renal sodium retention 149,150 and a higher risk of hyperkalaemia.151”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [149]
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Metadata
- Authors
- de Châtel, R., Weidmann, P., Flammer, J., Ziegler, W. H., Beretta-Piccoli, C., Vetter, W., & Reubi, F. C.
- Affiliations
- University of Bern (CH)
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 1977-12
- Volume
- 12
- Issue
- 6
- Pages
- 412-421
- ISSN
- 0085-2538 (ISSN-L)
- OpenAlex
- W1963655685
- Cited by
- 182
- References
- 45
- Citations by year
- 2022: 2 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 1 · 2012: 1
- FWCI
- 5.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Kidney International (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- diabetes mellitus, plasma renin activity, aldosterone, catecholamines, blood pressure, orthostatic hypotension, hypertension, body sodium, ACTH, adrenal function, urinary electrolytes, blood volume, plasma potassium, exchangeable sodium, renin-angiotensin system, cortisol, aldosterone regulation
- MeSH terms
- Adult, Aged, Aldosterone, Blood Pressure, Blood Volume, Catecholamines, Diabetes Mellitus, Female, Heart Rate, Humans, Hypertension, Renal, Male, Middle Aged, Renin, Sodium, Diabetes Complications
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