THE ACUTE EFFECT OF SMOKING ON SYSTEMIC HEMODYNAMICS, KIDNEY AND ENDOTHELIAL FUNCTIONS IN INSULIN-DEPENDENT DIABETIC-PATIENTS WITH MICROALBUMINURIA

The acute effect of smoking upon arterial blood pressure, urinary albu min excretion rate, glomerular filtration rate and transcapillary esca pe rate of albumin were investigated in nine normotensive insulin-depe ndent diabetic patients with microalbuminuria, who had been smoking fo r 19 (range 4-30) years. In a prospective, open randomized cross-over design, patients were investigated with and without smoking three ciga rettes per hour during a 5.5-h period. A rise in systolic blood pressu re and heart rate (Takeda TM2420, median (range)) was observed during the smoking day (10 (-11 to 14) mmHg and 8 (-1 to 19) beats min(-1)), compared to the non-smoking day (1 mmHg (-7 to 13) (p=0.05) and 0 beat s min(-1) (-2 to 4) (p<0.01)). Urinary albumin excretion rate (ELISA), glomerular filtration rate (plasma clearance of Cr-51-EDTA) and trans capillary escape rate of albumin (I-125-albumin) remained the same wit h or without smoking. Our study suggests that heavy smoking induces an abrupt rise in systolic blood pressure and heart rate, while vascular leakage of albumin and glomerular filtration rate remain unaltered in normotensive insulin-dependent diabetic patients with microalbuminuri a who had been smoking for several years.