Premium
RENAL FUNCTION AND BLOOD‐PRESSURE REACTION DURING EXERCISE IN DIABETIC AND NON‐DIABETIC CHILDREN AND ADOLESCENTS: A Pilot Study
Author(s) -
HERMANSSON Göran,
LUDVIGSSON JOHNNY
Publication year - 1980
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1980.tb15325.x
Subject(s) - medicine , excretion , renal function , diabetes mellitus , diabetic nephropathy , basal (medicine) , albumin , endocrinology , urine , blood pressure
. Hermansson, G. and Ludvigsson, J. (Department of Pediatrics, University Hospital, Linköping, Sweden). Renal function and blood‐pressure reaction during exercise in diabetic and non‐diabetic children and adolescents. A pilot study. Acta Paediatr Scand, Suppl. 283: 86, 1980.—In order to analyse whether protein excretion during exercise is an earlier sign of nephropathy in children and adolescents with juvenile diabetes than protein excretion during basal conditions, urinary excretion of albumin and beta‐2‐micro‐globulin was studied, during a basal 24‐hour period and during exercise, in 55 patients with insulin‐dependent diabetes (age 8–20 years; duration of disease 9 months‐17.5 years). Similar determinations were made in 55 non‐diabetics matched to the patients according to age, sex and weight. Mean glomerular filtration rate was lower in diabetics than in non‐diabetics (109, compared to 131 ml/min/1.73; p <0.001) partly due to errors in urine collection in the diabetics. Urinary albumin excretion during basal period and exercise was the same in patients and controls, but in the age group of 16–20 years the increase in albumin excretion during exercise was greater in the diabetics. There was no increase in albumin excretion during exercise in children below 10 years of age or with a duration of diabetes of 2 years or less. Methodological problems such as degree of hydration, choice of work loads and laboratory method for determining urinary albumin are discussed, and may contribute to the absence of significant differences in albumin excretion between diabetics and non‐diabetics. Beta‐2‐microglobulin excretion was greater in diabetics compared with controls both during basal conditions and during exercise ( p <0.001 and p <0.05 respectively). Exercise test did not give any further information on beta‐2‐microglobulin excretion than basal excretion. The reason for elevated beta‐2‐microglobulin excretion in diabetics is not clear but the degree of metabolic control may be one factor of importance. Systolic blood pressure during exercise increases with increasing age but this goes parallel to increasing duration of diabetes making it difficult to analyse what is most important for protein excretion. Further studies are necessary in order to evaluate exercise test as a provocation for albumin excretion in diabetic children and adolescents, and to find out the significance of elevated beta‐2‐microglobulin in diabetics compared with controls.