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Volume Homeostasis and Blood Pressure in Diabetic States

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The Kidney and Hypertension in Diabetes Mellitus

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Summary

Extra-cellular sodium and fluid volume expansion as measured using the isotopic technique of Total Exchangeable Sodium measurements is commonly seen in patients with both IDDM and NIDDM. The exact cause is not known but plausible factors include increased capillary permeability and subtle renal alterations in sodium handling. Intravascular volume is not expanded.

In IDDM patients with nephropathy and hypertension Total Exchangeable Sodium is further increased and positively related to Blood Pressure. By contrast Total Exchangeable Sodium is not clearly expanded in NIDDM patients with hypertension ab initio and is not related to blood pressure. In IDDM patients free of complications the renin-angiotensin-aldosterone system behaves normally. In nephropathy angiotensin 11 may be playing a role in hypertension in some patients. In NIDDM patients without nephropathy plasma renin is suppressed in both normotensive and hypertensives.

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Author information

Authors and Affiliations

  1. Diabetes Unit, Limerick Regional General Hospital, Limerick, Ireland

    James A. O’Hare MD, FRCPI, MRCP

  2. Department of Medicine, University Hospital, Cork, Ireland

    J. Barry Ferriss MD, FRCPI, FRCP

Authors
  1. James A. O’Hare MD, FRCPI, MRCP
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  2. J. Barry Ferriss MD, FRCPI, FRCP
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Editor information

Editors and Affiliations

  1. Medical Department M (Diabetes & Endocrinology), Aarhus Kommunehospital, Aarhus University Hospital, Aarhus C, Denmark

    Carl Erik Mogensen

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O’Hare, J.A., Ferriss, J.B. (1998). Volume Homeostasis and Blood Pressure in Diabetic States. In: Mogensen, C.E. (eds) The Kidney and Hypertension in Diabetes Mellitus. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-6752-0_31

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  • DOI: https://doi.org/10.1007/978-1-4757-6752-0_31

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-6754-4

  • Online ISBN: 978-1-4757-6752-0

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