Aims/hypothesis. The pre-clinical phase of diabetic nephropathy is characterised by increased glomerular filtration rate and episodes of
microalbuminuria. The cause of the microalbuminuria has been variably ascribed to alterations of the size or charge selective
barriers of the glomerulus or both or as a consequence of the haemodynamic changes. Our aim was to investigate very early
albumin permeability alterations in isolated glomeruli which were not subject to perfusion pressure.¶
Methods. Isolated glomeruli were studied from 120 male Wistar rats, divided into three groups: streptozotocin-treated, streptozotocin-treated
with insulin pellet implants, and controls. From each group ten animals were killed at 7, 14, 28, and 56 days after induction.
Study variables included blood pressure, proteinuria, iopamidol clearance, albumin permeability and glomerular area. Subsequently,
albumin permeability, proteinuria, and iopamidol clearance were determined in an additional group of 40 diabetic animals studied
at 24, 72, 96, and 120 h after induction.¶
Results. Albumin permeability increased steadily from induction in streptozotocin-treated animals, reaching a plateau at approximately
120 h. Glomerular filtration rate was shown to increase significantly at approximately 7 days and proteinuria correlated with
it. Glomerular hypertrophy was observed both in streptozotocin-treated animals and in streptozotocin-treated rats with insulin
pellet implants. Strict blood glucose control delayed the appearance of the permeability defect in isolated glomeruli and
inhibited the increase in glomerular filtration in intact animals. It did not prevent glomerular hypertrophy.¶
Conclusion/interpretation. An albumin permeability defect exists early in isolated non-perfused glomeruli from streptozotocin-treated rats and seems
to be independent of glomerular filtration rate alterations. [Diabetologia (2000) 43: 235–241]
Keywords Diabetic nephropathy, albumin permeability, streptozotocin, blood glucose, proteinuria.
Received: 17 August 1999 and in revised form: 11 November 1999