Abstract:
The aim of the study was to study the state of renal regulation of sodium homeostasis during water-salt loading and the value of the possible functional insufficiency of the tubular part of the nephron by changing the excretion of sodium from the body in patients with type I diabetes mellitus with stage I chronic kidney disease. We have studied the ability of the kidneys to regulate sodium homeostasis in patients with diabetic nephropathy in comparison with healthy people. The study involved 11 healthy people aged 24 to 53 years, an average of 38.3±5.63 years and 11 patients with type I diabetes with stage 1 chronic kidney disease aged 40 to 65 years, an average of 52±4.2 of the year. Renal function was studied under conditions of water-salt loading – drinking in the morning on an empty stomach after emptying the bladder of 0.5% aqueous sodium chloride solution in an amount of 0.5% of body weight for 3–5 minutes. When studying the ion-regulating function of the kidneys, it was found that the kidneys differentially remove ions from the body. If in healthy people with spontaneous daily diuresis, on average, the excretion of sodium and potassium ions is the same in magnitude, then with a water-salt load, the kidneys excrete mainly sodium. Thus, the concentration of sodium and its excretion was 3–5 times higher than the excretion of potassium in the urine. Consequently, the ion-regulating system provides priority excretion of sodium in the urine, both in relation to potassium and water. It has been established that in patients with type I diabetes mellitus with stage 1 chronic kidney disease, the same regulatory mechanisms are activated that provide osmotic homeostasis, as in healthy individuals. The increase in sodium excretion revealed by us in patients may indicate functional insufficiency of tubules for sodium transport. All human studies were conducted in compliance with the rules of the Helsinki Declaration of the World Medical Association "Ethical principles of medical research with human participation as an object of study". Informed consent was obtained from all participants.
