La función renal y la presión arterial en la diabetes mellitus tipo 1

Resumen

Introduction: Persistent microalbuminuria is the accepted markerfor early detection of a high risk of developing diabetic nephropathy in patients diagnosed with Type I Diabetes mellitus. The Ambulatory Blood Pressure Monitoring (ABPM) evaluates the circadian variations of blood pressure while awake and asleep. Objective: To show the renalfunction characteristics and the data provided by ABPM in a cohort of insulin dependent diabetic children referred to our hospital. Material and methods: A total of 61 patients with an age range between 6 and 17 years were studied. In each child blood pressure monitoringwas arranged,the glomerular ?ltration rate in 24hour urine was estimated, and glycosylated haemoglobin (HbA1c), total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, was measured. Results: None ofthe cases showed persistent microalbuminuria. The renal function showed an increase in the glomerular ?ltration rate (146.6 ±22ml/minute/1.73 m2 ). In 39% of the cases there was no drop in systolic blood pressure during the night, whereas 11% ofthe patients in our series had a decrease in diastolic pressure. The cases were analysed depending on whether or nottherehadbeenaphysiologicalarterialordiastolicpressuredropduring thenight:therewere no signi?cant differences in anthropometric data, glycosylated haemoglobin (HbA1c) levels, total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, glomerular ?ltration rate (GFR), proteinuria and microalbuminuria between both groups. Conclusion: In Type I Diabetes Mellitus a decrease in the physiological blood pressure during the night is a frequent ?nding. There is also an increase in the glomerular ?ltration rate.