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Brain natriuretic peptide increases urinary albumin and alpha‐1 microglobulin excretion in Type 1 diabetes mellitus
Author(s) -
McKenna K.,
Smith D.,
Moore K.,
Glen A.,
Tormey W.,
Thompson C. J.
Publication year - 2001
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.0742-3071.2001.00569.x
Subject(s) - medicine , endocrinology , excretion , placebo , natriuretic peptide , creatinine , atrial natriuretic peptide , diuresis , renal function , urine , albumin , diabetes mellitus , heart failure , alternative medicine , pathology
Atrial natriuretic peptide (ANP) increases urinary albumin excretion in Type 1 diabetes mellitus (DM). Brain natriuretic peptide (BNP) is structurally and functionally related to ANP, but its effect on urine albumin excretion rate (UAER) is unknown. Aims To compare the albuminuric effects of intravenous infusion of ANP and BNP, and to assess the effect of both peptides on tubular protein excretion. Methods Eight subjects with Type 1 DM were randomised to a three leg, double blind, and placebo controlled study. On each study day, subjects were euglycaemic clamped and subsequently water loaded (20 mL/kg orally, plus urine losses) to steady state diuresis. When in steady state, creatinine clearance was estimated in three separate 1 hour periods. At the end of the first period, a 1 hour intravenous infusion of either placebo, ANP 0.025 μg/kg/min, or BNP 0.025 μg/kg/min was administered. There followed a 1 hour recovery period. Urine was collected at 15 min intervals for estimation of urine albumin (ACR) and α1 microglobulin creatinine ratio (MCR). Results were analysed by anova . Results Creatinine clearance was similar on the three study days, and was unaltered by any infusion. ACR was unaltered by placebo (1.3 ± 0.5–1.2 ± 0.4 mg/mmol, mean ± SD, p = 0.81), but increased compared to placebo with infusion of both ANP (1.2 ± 0.4–9.8 ± 8.4 mg/mmol, P = 0.0004), and BNP (1.1 ± 0.4–13.4 ± 8.6 mg/mmol, P = 0.0001). The MCR was unaltered by placebo infusion ( P = 0.89), but increased compared with placebo after infusion of ANP (5.4 ± 0.9–12.3 ± 4.2 mg/mmol, P < 0.0001), and BNP (5.4 ± 0.8–12.1 ± 2.5 mg/mmol, P < 0.0001). Conclusions Intravenous infusion of BNP and ANP both increase the urine excretion of albumin and the tubular protein α1 microglobulin, independent of creatinine clearance. Diabet. Med. 18, 973–978 (2001)