Document Detail


Renal effects of insulin in man.
MedLine Citation:
PMID:  9377725     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We review some of the effects that insulin exerts on glomerular and tubular functions. In healthy subjects, insulin has little or no effect on renal hemodynamics, glomerular filtration rate, or permeability to albumin. In patients with noninsulin-dependent diabetes, hyperinsulinemia selectively increases urinary albumin excretion. In vivo, euglycemic hyperinsulinemia is associated with reduced urinary sodium excretion both under conditions of forced and normal diuresis. Whether the principal site of this action is the proximal or distal tubule remains somewhat controversial. The effect, however, is not mediated by insulin-induced hypokalemia and antikaliuresis, as it is still observed when plasma potassium concentrations and urinary potassium excretion are maintained. Hyperglycemia potentiates insulin antinatriuresis through an effect on the proximal tubule (sodium-glucose cotransport). Insulin antinatriuresis is accompanied by a reduction in the urinary excretion of uric acid. Both the antinatriuretic and antiuricosuric effect of insulin are preserved in states of insulin resistance of glucose metabolism (obesity, diabetes, essential hypertension). Thus, in insulin resistant individuals compensatory hyperinsulinemia imposes a chronic antinatriuretic and antiuricosuric pressure on the kidney. This may provide an explantation for the clustering of insulin resistance with hypertension and hyperuricemia.
Authors:
A Quiñones-Galvan; E Ferrannini
Related Documents :
22526615 - Screening for diabetes: hope and despair.
7729295 - Incidence and determinants of elevated urinary albumin excretion in pima indians with n...
7987655 - Evidence of oxidant injury and tubular damage in early diabetic nephropathy.
153095 - An inhibitory substance of glyceraldehyde 3-phosphate dehydrogenase in urine of diabeti...
2272185 - Gossypol-induced inhibition of glucose uptake in human ejaculated spermatozoa may be me...
19692135 - Neonatal diabetes in a child positive for islet cell antibodies at onset and kir6.2 act...
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of nephrology     Volume:  10     ISSN:  1121-8428     ISO Abbreviation:  J. Nephrol.     Publication Date:    1997 Jul-Aug
Date Detail:
Created Date:  1997-11-07     Completed Date:  1997-11-07     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9012268     Medline TA:  J Nephrol     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  188-91     Citation Subset:  IM    
Affiliation:
Metabolism Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Diabetes Mellitus, Type 2 / physiopathology
Glomerular Filtration Rate / drug effects
Humans
Insulin / physiology*
Kidney / drug effects,  physiology*
Kidney Tubules, Proximal / physiopathology
Monosaccharide Transport Proteins / physiology
Natriuresis / physiology
Potassium / urine
Sodium / urine
Uric Acid / urine
Chemical
Reg. No./Substance:
0/Monosaccharide Transport Proteins; 11061-68-0/Insulin; 69-93-2/Uric Acid; 7440-09-7/Potassium; 7440-23-5/Sodium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Neurogenic factors and hypertension in chronic renal failure.
Next Document:  Endothelial function in hypertension.