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[Basal and reactive renin and aldosterone secretion in arterial hypertension of insulin dependent diabetics].

The aim of the study was to assess the significance of the renin-angiotensin-aldosterone system (R-A-A) in the pathogenesis of arterial hypertension in patients with diabetes type I (IDDM). Testing was accomplished in the hospital conditions in a group of 131 patients with long-term IDDM, who beside of diabetes mellitus and its chronic complications did not show any symptoms of additional diseases. The patients were divided in 5 groups (A-E) depending on the type of coexisting late diabetic complications. The control group was consisted of 20 healthy persons matched for sex and age. In each case the following tests were performed: measurement of blood pressure in succumbent position, daily profile of glycemia and glucosuria, Hb A1 level, ophthalmoscopy, functional assessment of kidney and autonomic system status. Tenin activity in plasma (ARO) and plasma aldosterone (ALD) were determined in basal (after 6 h of succumbent position) and after i.v. administration of 40 mg of furosemide and 3 h of standing position (reactive values). In all groups under study the significant decrease of average, basal and reactive ARO was found in comparison with the control group. This abnormality was the most distinct in subjects with diabetic nephropathy. The autonomic neuropathy was abolishing this tendency. The mean concentration ob basal ALD was in all diabetic subgroups similar as in the controls. The mean reactive ALD was however significantly decreased. In diabetes complicated by retinopathy the negative correlation between ARO and systolic, diastolic and mean blood pressure existed. In diabetes complicated by nephropathy the dependence between blood pressure and ARO and ALD was not found.(ABSTRACT TRUNCATED AT 250 WORDS)