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Title: Impaired Glucose Tolerance May Prove Vital Determinant Of Age-Associated Renal Decline

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Journal of Hypertension 2001 Vol 19 pp 2257-2264. "Glucose tolerance and age-associated decline in renal function of hypertensive patients"
12/13/2001 11:31:05 AM
By Veronica Rose

Impaired glucose tolerance is seldom searched for say French researchers. However, they consider it may prove a vital determinant of age associated decline in renal function. While it is believed that renal function decreased with age in the general population, the determinants of this age-associated evolution are poorly understood. Researchers from L'Hopital Lapeyronie in Montpelier suggest hypertension and diabetes, which are two major causes of chronic renal failure, may therefore accelerate this decline in the elderly. A total of 227 patients aged between 20 and 69 years who had never been treated as essential hypertensives were assessed for urinary clearance [99mTc] diethylene triaminopentaacetic acid (DTPA)(glomerular filtration rate) and [131 1] hippuran (effective renal plasma flow). Four percent of the patients in the study, previously unknown to have diabetes mellitus were identified through the oral glucose tolerance test. A further 24 percent had impaired glucose tolerance, which proved normal in 72 percent of the patients. In the population of 218 non-diabetic subjects, there was an inverse correlation between the glomerular filtration rate and both age and arterial blood pressure, but it positively correlated with effective renal plasma flow, filtration fraction and fasting plasma glucose. Both age and blood pressure were independent determinants of renal plasma flow according to multivariate analysis, whilst renal plasma flow, age and fasting plasma glucose independently determined the glomerular filtration rate. Researchers noted that the slope of the regression line which related glomerular filtration rate to age, was steeper in patients whose glucose tolerance was impaired than among those with normal glucose tolerance (-1.52 plus/minus 0.28 vs -0.65 plus/minus 0.12, P<0.01).

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