Vascular homeostasis in early (normo-albuminuric) type 2 diabetic nephropathy

Abstract

Background: Renal microvascular disease and reduction in peritubular capillary flow are generally observed in type 2 diabetic nephropathy (DN). Earlier therapeutic strategy with vasodilators has improved renal function in normo-albuminuric type 2 DN. Objective: Study the mechanism of vascular homeostasis in twenty patients associated with normo-albuminuric type 2 DN. Results: Angiogenic factors were observed in normo-albuminuric type 2 DN, where vascular endothelial growth factor (VEGF), was 420 ± 341 vs. 428±291 pg/mL (normal), and vascular endothelial growth factor - receptor 1 (VEGF-R1) was 60±12 vs. 49±5 ng/mL (normal), which were not significantly different from the controls. Anti-angiogenic factors were observed in normo-albuminuric type 2 DN, where angiopoietin-2, was 2309±1125 vs. 1671±835 pg/mL (normal), and vascular endothelial growth factor - receptor 2 (VEGF-R2) was 5715±1400 vs.6126 ± 1060 ng/mL (normal), which were not significantly different from the controls. Conclusion: The mechanism of vascular homeostasis was adequately functional in normo-albuminuric type 2 DN. This mechanism may explain the positive response to vasodilators and improved renal function in early stage of type 2 DN following the vasodilator treatment.