Abnormal carbohydrate metabolism in renal failure

O’Brien, John P.; Sharpe, Alton R.

doi:10.1016/s0026-0495(65)80011-7

Cited by 23 publications

(16 citation statements)

References 67 publications

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“…There is accumulating evidence, reviewed by O'Brien and Sharpe (1), that the influence of the kidney on carbohydrate metabolism may be due to an important role in insulin metabolism in addition to its function as an organ of glucose conservation and gluconeogenesis. There are, however, a number of contradictory observations to be reconciled.…”

Section: Introductionmentioning

confidence: 99%

The Renal Handling of Insulin*

Chamberlain¹,

Stimmler²

1967

J. Clin. Invest.

172

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Summary. The renal handling of insulin was studied by insulin immunoassay in arterial blood, renal venous blood, and urine of fasting patients with normal renal function and in peripheral venous blood and urine of normal subjects and patients with renal disease before and after an oral glucose load. A renal arteriovenous insulin concentration difference of approximately 29% was found and suggests that in normal subjects renal insulin clearance is significantly in excess of glomerular filtration rate. The insulin excreted in the urine of normal individuals at no time exceeded 1.5% of the load filtered at the glomerulus. This contrasts with the finding of a urinary insulin clearance approaching glomerular filtration rate in patients with severely impaired renal tubular function.It is suggested that insulin is normally filtered at the glomerulus and then almost completely reabsorbed or destroyed in the proximal tubule. If reabsorption occurs, as seems more likely, reabsorbed insulin does not return to the renal vein and is presumably utilized in renal metabolism together with insulin taken up directly from the blood.Caution is advised in the use of urinary insulin concentration or excretion as an index of serum insulin level or insulin secretion because a very small and variable proportion of filtered insulin appears in the urine in normal subjects, and major changes in urinary insulin excretion may arise as a result of minor tubular defects.

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Section: Introductionmentioning

confidence: 99%

The Renal Handling of Insulin*

Chamberlain¹,

Stimmler²

1967

J. Clin. Invest.

172

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“…However, following intravenous injection of pentobarbital in patients with chronic liver disease, neuropsychic manifestations [1] and the plasma disappearance of the drug [2] have been found normal. Considering these controversial opinions, pento barbital pharmacokinetics was studied in patients with cirrhosis.…”

Section: Pentobarbital Pharmacokinetics In Cirrhosismentioning

confidence: 99%

“…Its low value may indicate high transepithelial ion permeabilities. Intravenous infusion of fructose causes a rapid depletion of hepatic adenine nucleotides in rat liver [1], These studies were undertaken to answer the question whether this action of fructose affects hepatic bile flow (HBF).…”

mentioning

confidence: 99%

“…(3) In addition, small amounts of unconjugated bilirubin seemed to be actually present in bile in the most severe conjugating defects. High percentage of free fatty acids, mainly unsaturated which is found in breast milks thought to be responsible of jaundice in breast-fed newborns has been shown to inhibit bilirubin glucuroconjugation in vitro [1]. Since fatty acids binding by protein Z has been found [2], we wondered if such inhibitory milks could exert a competitive action in protein Z anion-binding.…”

mentioning

confidence: 99%

“…The transfer of bilirubin and other organic anions across the plasma membrane of liver cell is due to a mechanism of specific transport, still poorly understood. In this process it seem to be important: (a) the binding between anion and albumin in plasma; (b) the liver cell plasma membrane composition; (c) the binding of the anion with some well identified cytoplasmatic proteins (Y and Z) [1], Although it has been already demonstrated that in rat liver protein Y has for BSP a binding affinity (K.i 3.5 x 10° M/g) lower than the albumin (Ki 1.7 x 107 M/g, K.2 1.4 x |0 6 M/g), some authors [2,3] suggest that 'the net flux of organic anion across the sinusoidal plasma membrane of the liver cells is determined by the amount and binding affinity of albumin in plasma, and the amount and binding affinities of Y and Z in the cytoplasm'. We have determined the affinity constants for BSP with respect to rat plasma and liver supernate in toto using flow dialysis.…”

mentioning

confidence: 99%

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