We measured plasma and urine ATIII and FgE levels by specific and sensitive radioimmunoassays
(RIA) in 25 patients with diabetic nephropathy (DN) (proteinuria > lg/day) and in
17 patients with non-diabetic glomerulonephritis (GN), matched for degree of proteinuria.
Plasma ATIII in DN (mean ± SD, 19.37 ± 2.40 mg/dl) were lower than in diabetics without
renal involvement (21.84 ± 2.86 mg/dl). Total urine ATIII was directly related to
proteinuria and inversely to creatinine clearance. In GN patients, plasma ATIII levels
were even lower (16.84 ± 3.78 mg/dl), but the amount of urine ATIII fell when creatinine
clearance decreased to below 37 ml/min. Serum FgE levels were elevated in both groups
and this was associated with increased total urine FgE excretion. In DN, serum and
urine FgE were directly related to proteinuria but inversely to creatinine clearance,
indicating an increase in intraglomerular fibrin deposition as the disease progressed.
These findings suggest that in DN, intravascular thrombosis might play an intermediary
role as mediator of glomerular injury. Furthermore, the monitor of urine ATIII and
FgE reflected the severity of DN and could be useful indices of the progression of
the disease.
