Differential circadian pattern of water and Na excretion rates in the metabolic syndrome

Fézeu, Léopold; Bankir, Lise; Hansel, Boris; Guerrot, Dominique

doi:10.3109/07420528.2014.917090

Cited by 10 publications

(5 citation statements)

References 32 publications

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“…They showed that the circadian pattern of urine flow rate/urine concentration and/or sodium excretion rate may be disturbed in some subjects. An excessive urine concentration during daytime, limiting sodium and/or water excretion rate, is subsequently compensated at night by the pressure-natriuresis mechanism [59,60,61,62,63]. Accordingly, measurement of U osm in overnight urine samples may not be representative of 24-h urine.…”

Section: Discussionmentioning

confidence: 99%

Validation of Surrogates of Urine Osmolality in Population Studies

et al. 2017

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Background: The importance of vasopressin and/or urine concentration in various kidney, cardiovascular, and metabolic diseases has been emphasized recently. Due to technical constraints, urine osmolality (U_osm), a direct reflect of urinary concentrating activity, is rarely measured in epidemiologic studies. Methods: We analyzed 2 possible surrogates of U_osm in 4 large population-based cohorts (total n = 4,247) and in patients with chronic kidney disease (CKD, n = 146). An estimated U_osm (eU_osm) based on the concentrations of sodium, potassium, and urea, and a urine concentrating index (UCI) based on the ratio of creatinine concentrations in urine and plasma were compared to the measured U_osm (mU_osm). Results: eU_osm is an excellent surrogate of mU_osm, with a highly significant linear relationship and values within 5% of mU_osm (r = 0.99 or 0.98 in each population cohort). Bland-Altman plots show a good agreement between eU_osm and mU_osm with mean differences between the 2 variables within ±24 mmol/L. This was verified in men and women, in day and night urine samples, and in CKD patients. The relationship of UCI with mU_osm is also significant but is not linear and exhibits more dispersed values. Moreover, the latter index is no longer representative of mU_osm in patients with CKD as it declines much more quickly with declining glomerular filtration rate than mU_osm. Conclusion: The eU_osm is a valid marker of urine concentration in population-based and CKD cohorts. The UCI can provide an estimate of urine concentration when no other measurement is available, but should be used only in subjects with normal renal function.

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Section: Discussionmentioning

confidence: 99%

Validation of Surrogates of Urine Osmolality in Population Studies

et al. 2017

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“…Yet, potassium excretion is relatively fast compared with that of other electrolytes. In rats and humans, the excretion rate of potassium during daytime is about three times higher than that during nighttime, a much higher day/night ratio than that observed for water and sodium, while creatinine is excreted almost at the same rate during day and night (55,70,152,176). Several studies also showed that potassium excretion increases rapidly after an acute intake of potassium, independently of any change in aldosterone level.…”

Section: Possible Role Of the ␣-Cell And Glucagon In Potassium Homeostasismentioning

confidence: 96%

Glucagon actions on the kidney revisited: possible role in potassium homeostasis

Bankir

Bouby

Blondeau

et al. 2016

American Journal of Physiology-Renal Physiology

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It is now recognized that the metabolic disorders observed in diabetes are not, or not only due to the lack of insulin or insulin resistance, but also to elevated glucagon secretion. Accordingly, selective glucagon receptor antagonists are now proposed as a novel strategy for the treatment of diabetes. However, besides its metabolic actions, glucagon also influences kidney function. The glucagon receptor is expressed in the thick ascending limb, distal tubule, and collecting duct, and glucagon regulates the transepithelial transport of several solutes in these nephron segments. Moreover, it also influences solute transport in the proximal tubule, possibly by an indirect mechanism. This review summarizes the knowledge accumulated over the last 30 years about the influence of glucagon on the renal handling of electrolytes and urea. It also describes a possible novel role of glucagon in the short-term regulation of potassium homeostasis. Several original findings suggest that pancreatic α-cells may express a "potassium sensor" sensitive to changes in plasma K concentration and could respond by adapting glucagon secretion that, in turn, would regulate urinary K excretion. By their combined actions, glucagon and insulin, working in a combinatory mode, could ensure an independent regulation of both plasma glucose and plasma K concentrations. The results and hypotheses reviewed here suggest that the use of glucagon receptor antagonists for the treatment of diabetes should take into account their potential consequences on electrolyte handling by the kidney.

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“…Unfortunately, this 'knowledge' does not mean that the effects can, consequently, be successfully treated, since this depends on the particular nature of the core problem causing the disorder. Obesity often carries with it severe additional consequences, including the loss of mobility [341,342] and misadjusted water/electrolyte handling [343] or thermoregulation [344,345]. Some of these effects can be attributable simply to the effect of the extra body mass to be held, physically supported/carried, and provided with adequate nutrients and oxygen supply through an (also altered) blood flow; a burden additional to the metabolic and regulatory distortions that cause the obesity hypertrophic and/or hyperplastic disordered growth.…”

Section: Other Aspects Of Msmentioning

confidence: 99%

The Metabolic Syndrome, a Human Disease

Alemany

2024

IJMS

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This review focuses on the question of metabolic syndrome (MS) being a complex, but essentially monophyletic, galaxy of associated diseases/disorders, or just a syndrome of related but rather independent pathologies. The human nature of MS (its exceptionality in Nature and its close interdependence with human action and evolution) is presented and discussed. The text also describes the close interdependence of its components, with special emphasis on the description of their interrelations (including their syndromic development and recruitment), as well as their consequences upon energy handling and partition. The main theories on MS’s origin and development are presented in relation to hepatic steatosis, type 2 diabetes, and obesity, but encompass most of the MS components described so far. The differential effects of sex and its biological consequences are considered under the light of human social needs and evolution, which are also directly related to MS epidemiology, severity, and relations with senescence. The triggering and maintenance factors of MS are discussed, with especial emphasis on inflammation, a complex process affecting different levels of organization and which is a critical element for MS development. Inflammation is also related to the operation of connective tissue (including the adipose organ) and the widely studied and acknowledged influence of diet. The role of diet composition, including the transcendence of the anaplerotic maintenance of the Krebs cycle from dietary amino acid supply (and its timing), is developed in the context of testosterone and β-estradiol control of the insulin-glycaemia hepatic core system of carbohydrate-triacylglycerol energy handling. The high probability of MS acting as a unique complex biological control system (essentially monophyletic) is presented, together with additional perspectives/considerations on the treatment of this ‘very’ human disease.

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Differential circadian pattern of water and Na excretion rates in the metabolic syndrome

Cited by 10 publications

References 32 publications

Validation of Surrogates of Urine Osmolality in Population Studies

Validation of Surrogates of Urine Osmolality in Population Studies

Glucagon actions on the kidney revisited: possible role in potassium homeostasis

The Metabolic Syndrome, a Human Disease

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