糖尿病性腎症の早期診断に対するアルギニン負荷試験の有用性

Abstract

Diagnostic significance of arginine loading test in the early stage of diabetic nephropathy is evaluated in relation to the histological findings of renal biopsy specimens. The subjects were 30 diabetics, divided into 3 groups (D0, DⅠ and DⅡ) according to the stage of glomerular diffuse lesion based on Gellman's criteria. Glomerular filtration rate (GFR), urinary albumin and urinary β2 microglobulin (β2MG) were measured before and after 30 g arginine loading by intravenous infusion. Before arginine loading, GFR was significantly lower in DⅠ and DⅡ than in D0, the excretion of urinary albumin was significantly higher in DⅡ than in D0, and the excretion of urinary β2MG was significantly higher in DⅡ than in D0 and DⅠ. After arginine loading, GFR was significantly lower in DⅡ than in D0, and the excretion of urinary albumin was significantly higher in DⅠ and DⅡ than in D0, however, no significant difference was seen in the excretion of urinary β2MG among these three groups. These results suggest that the arginine loading test is one useful method for diagnosis of early diabetic nephropathy.