Diurnal variation in urinary protein excretion in diabetic nephropathy

Nephrol Dial Transplant. 1991;6(4):238-43. doi: 10.1093/ndt/6.4.238.

Abstract

We examined the diurnal variation in urinary excretion rate of albumin, IgG and beta 2-Microglobulin (beta 2-M) in healthy volunteers (n = 24), and in patients with type I diabetes mellitus having normal albumin excretion rate (less than 20 micrograms/min; n = 16), incipient diabetic nephropathy (albumin excretion rate 20-200 micrograms/min; n = 12) and clinical diabetic nephropathy (albumin excretion rate greater than 200 micrograms/min; n = 12). Diurnal variation was defined as [(overnight minus daytime): daytime excretion rate] times 100%. Median diurnal variation in albumin excretion rate in the various groups varied from -32 to -57%, and in IgG excretion rate from -42 to -65%, being not significantly different between the proteins or between the groups. Diurnal variation in beta 2-M excretion rate was similar in healthy volunteers and in patients with normal albumin excretion rate or incipient diabetic nephropathy (median -36 to -43%), but significantly reduced in patients with clinical diabetic nephropathy (median 0%; P less than 0.005), nine of whom had elevated beta 2-M excretion rates, suggesting tubular dysfunction. Except for beta 2-M excretion rate in patients with clinical diabetic nephropathy, the diurnal variations in albumin excretion rate, IgG excretion rate and beta 2-M excretion rate were larger than the diurnal variation in creatinine excretion rate (median -7 to -11%, P less than 0.005). Diurnal variations in albumin excretion rate and IgG excretion rate were highly correlated (r = 0.89, P less than 0.00001). These data suggest that similar mechanisms may account for diurnal variations in albumin excretion rate and IgG excretion rate.(ABSTRACT TRUNCATED AT 250 WORDS)

MeSH terms

  • Adult
  • Albuminuria / complications
  • Albuminuria / urine
  • Circadian Rhythm*
  • Creatinine / urine
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / urine
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / urine*
  • Female
  • Humans
  • Immunoglobulin G / urine
  • Male
  • Proteinuria / complications
  • Proteinuria / urine*
  • beta 2-Microglobulin / urine

Substances

  • Immunoglobulin G
  • beta 2-Microglobulin
  • Creatinine