The effect of glucagon infusion on kidney function in short-term insulin-dependent juvenile diabetics

Parving, Hans‐Henrik; Christiansen, John; Noer, Ivan; Tronier, B.; Mogensen, Carl Erik

doi:10.1007/bf00280519

Cited by 108 publications

(36 citation statements)

References 20 publications

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“…Furthermore it has been reported that increase of plasma glucagon may cause the elevated GFR (Parving et al 1985). These findings led us to consider that increase of plasma glucagon after ingestion of tuna fish meal may induce the elvated GFR, though measurements of plasma glucagon were not undertaken in the present study.…”

Section: Discussionmentioning

confidence: 81%

“…The mechanisms that mediate the acute renal response to a protein or amino acid load are not well defined, although some authors have considered that this response in induced by glucagon (Parving et al 1985), a liver-derived renal vasodilator (Premen 1985;Dratwa et al 1984) glomerulopressin (Alvestrand and Bergstrom 1984), tobule-glomerular feedback (Seney and Wright 1985), prostaglandins (Krishna et al 1988). In the present study, the mechanism of this response was not elucidated, but the finding that loading a vegetable protein did not increase GFR might provide some clarification.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of acute protein loads of different sources on renal function of patients with diabetic nephropathy.

Nakamura

Takasawa

Kashara

et al. 1989

Tohoku J. Exp. Med.

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To evaluate effects of acute loading of different proteins on renal function, glomerular filtration rate (GFR), albumin excretion rate (AER), and concentrations of plasma amino acids, 11 normal volunteers and 20 diabetic patients were studied before and after eating 1.0 g/kg body weight of either tuna fish meal or bean curd on separate days. In normal subjects, the mean baseline GFR was 115.8+9.5 ml/min/1.73 m2, and the mean GFRs after ingestion of tuna fish meal were 134.1± 15.5 (1 hr), 146.2 + 18.8 (2 hr), and 157.8±21.2 (3 hr), respectively. GFR did not significantly increase in normal subjects after ingestion of bean curd. GFR in diabetic patients with normoalbuminuria after ingestion of each protein was similar to the response in normal subjects. In diabetic patients with microalbuminuria, GFR did not significantly increase after ingestion of each protein. In diabetes with macroalbuminuria, GFR decreased after ingestion of tuna fish meal and did not significantly change after intake of bean curd. In both normal subjects and diabetic patients, urinary AER did not increase after each kind of protein loading. Plasma concentrations of alanine, glycine, and arginine, known to induce glomerular hyperfiltration, increased to a greater degree after ingestion of tuna fish meal than after administration of bean curd. These findings suggest that responses of GFR to acute protein loading may differ according to the amino acid composition of the protein ingested and to the stage of diabetic nephropathy. Diabetic nephropathy ; GFR ; glomerular hyperfiltration ; proteins of different sources ; composition of amino acids An elevated glomerular filtration rate (GFR) in uncomplicated type 1 (insulin dependent) diabetic patients has been confirmed for many years. As to the clinical significance of this phenomenon, Mogensen (1971Mogensen ( , 1976 recently reported that glomerular hyperfiltration in type 1 diabetes with an early stage of diabetic nephropathy might play an important role in subsequent development of late diabetic nephropathy.Although the exact mechanism that induces glomerular

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Effects of acute protein loads of different sources on renal function of patients with diabetic nephropathy.

Nakamura

Takasawa

Kashara

et al. 1989

Tohoku J. Exp. Med.

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“…In a recent study dealing with the effect of glucagon on kidney function in IDD patients we reported normal RPF values [16]. The patients in that study were selected among out-patients usually showing excellent metabolic control.…”

Section: Discussionmentioning

confidence: 99%

Increased kidney size, glomerular filtration rate and renal plasma flow in short-term insulin-dependent diabetics

et al. 1981

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Summary. Glomerular filtration rate (GFR), renal plasma flow (RPF) and kidney volume were measured in thirteen male subjects (mean age 30 years) with short-term insulin-dependent diabetes (mean duration of disease 2.4 years) and fourteen normal male subjects (mean age 29 years). GFR and RPF were measured by constant infusion technique using I125-iothalamate and 13q-hippuran. Kidney size was determined by means of ultrasound. GFR, RPF and kidney volume were increased in the diabetic patients compared to the normal controls, 144 versus 113 ml/ min • 1.73 m 2 (p < 0.0005), 627 versus 523 ml/ min x 1.73 m 2 (p < 0.0025) and 278 versus 224 ml/ 1.73 m 2 (p < 0.0005) respectively. Combining results from diabetic patients and controls revealed a positive correlation between kidney size and GFR (r = 0.70, p < 0.001) and between kidney size and RPF (r = 0.61, p < 0.001). Within the groups kidney size and RPF correlated significantly in the diabetics (p < 0.01) and the same was found for kidney size and GFR (0.025< p < 0.05), while no correlations were found in the normal group. GFR and RPF correlated in the diabetics when evaluated separately (r = 0.81, p < 0.001) and in the controls (r = 0.73, p < 0.001). The previous and present data suggest that the mechanisms of the elevated GFR in insulin-dependent diabetics are enhanced RPF, increased transglomerular hydrostatic pressure gradient and increased glomerular ultrafiltration coefficient. The increased kidney size is probably the main cause of the above alterations in the GFR determinants.

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“…There may be several determinants, such as an inappropriate rise in plasma glucagon and growth hormone in response to glucose during relative insulinopenia, 32,33 or changes in atrial natriuretic factor 34 or prostaglandins. Glucose can also be metabolized by the tubular cells and consequently affect GFR regulation.…”

Section: Discussionmentioning

confidence: 99%

Renal Changes on Hyperglycemia and Angiotensin-Converting Enzyme in Type 1 Diabetes

Marre

Bouhanick²,

Berrut³

et al. 1999

Hypertension

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Abstract-Hyperglycemia causes capillary vasodilation and high glomerular capillary hydraulic pressure, which lead to glomerulosclerosis and hypertension in type 1 diabetic subjects. The insertion/deletion (I/D) polymorphism of the angiotensin I-converting enzyme (ACE) gene can modulate risk of nephropathy due to hyperglycemia, and the II genotype (producing low plasma ACE concentrations and probably reduced renal angiotensin II generation and kinin inactivation) may protect against diabetic nephropathy. We tested the possible interaction between ACE I/D polymorphism and uncontrolled type 1 diabetes by measuring glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) during normoglycemia (Ϸ5 mmol/L) and hyperglycemia (Ϸ15 mmol/L) in 9 normoalbuminuric, normotensive type 1 diabetic subjects with the II genotype and 18 matched controls with the ID or DD genotype. Baseline GFR (145Ϯ22 mL/min per 1.73 m 2 ) and ERPF (636Ϯ69 mL/min per 1.73 m 2 ) of II subjects declined by 8Ϯ10% and 10Ϯ9%, respectively, during hyperglycemia; whereas baseline GFR (138Ϯ16 mL/min per 1.73 m 2 ) and ERPF (607Ϯ93 mL/min per 1.73 m 2 ) increased by 4Ϯ7% and 6Ϯ11%, respectively, in ID and DD subjects (II versus ID or DD subjects: Pϭ0.0007 and Pϭ0.0005, for GFR and ERPF, respectively). The changes in renal hemodynamics of subjects carrying 1 or 2 D alleles were compatible, with a mainly preglomerular vasodilation induced by hyperglycemia, proportional to plasma ACE concentration (Pϭ0.024); this was not observed in subjects with the II genotype. Thus, type 1 diabetic individuals with the II genotype are resistant to glomerular changes induced by hyperglycemia, providing a basis for their reduced risk of nephropathy. (Hypertension. 1999;33:775-780.)

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The effect of glucagon infusion on kidney function in short-term insulin-dependent juvenile diabetics

Cited by 108 publications

References 20 publications

Effects of acute protein loads of different sources on renal function of patients with diabetic nephropathy.

Effects of acute protein loads of different sources on renal function of patients with diabetic nephropathy.

Increased kidney size, glomerular filtration rate and renal plasma flow in short-term insulin-dependent diabetics

Renal Changes on Hyperglycemia and Angiotensin-Converting Enzyme in Type 1 Diabetes

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