Hormonal influence on renal function with particular reference to diabetes mellitus

Chapter 1 outlines the epidemiology, the functional stages, the pathogenesis and therapeutic aspects of renal disease in patients with insulin-dependent diabetes mellitus (IDDM). Several aspects of the pathogenesis of diabetic nephropathy (DN) are more extensively overviewed in sections on the influence of norepinephrine (NE) and the growth hormone-insulin-like growth factor-I (GH-IGF-I) axis on renal function. Both substances belong to hormonal systems that control renal haemodynamics in opposite ways: NE causes renal vasoconstriction, the GH-IGF-I-axis induces renal vasodilatation. Since the early stages of diabetic renal involvement are characterised by an imbalance in glomerular vasodilation and vasoconstriction, the possible role of these humoral systems in diabetic nephropathy (DN) is discussed. The role of 11B-hydroxysteriod dehydrogenase (11B-HSD) in protecting the mineralcorticoid receptor from activation by cortisol is briefly recapitulated in the context of abnormalities in sodium and volume homeostasis in IDDM.

	titlepages/contents
	chapter 1
	chapter 2
	chapter 3
	chapter 4
	chapter 5
	chapter 6
	chapter 7
	chapter 8
	chapter 9
	chapter 10
	chapter 11
	chapter 12
	publications
	references
	samenvatting
	complete thesis

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