Effects of insulin and lipid emulsion on renal haemodynamics and renal sodium handling in IDDM patients
Language English Country Germany Media print
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
8877292
DOI
10.1007/bf00400657
Knihovny.cz E-resources
- MeSH
- Diabetes Mellitus, Type 1 blood physiopathology urine MeSH
- Adult MeSH
- Glucose Clamp Technique MeSH
- Glycated Hemoglobin analysis MeSH
- Hemodynamics drug effects MeSH
- Glomerular Filtration Rate drug effects MeSH
- Infusions, Intravenous MeSH
- Inulin administration & dosage blood pharmacokinetics pharmacology MeSH
- Blood Glucose drug effects metabolism MeSH
- p-Aminohippuric Acid pharmacokinetics MeSH
- Fatty Acids, Nonesterified blood MeSH
- Kidney Tubules drug effects physiology physiopathology MeSH
- Kidney blood supply drug effects physiopathology MeSH
- Humans MeSH
- Lithium pharmacokinetics MeSH
- Metabolic Clearance Rate drug effects MeSH
- Reference Values MeSH
- Renal Circulation drug effects MeSH
- Sodium urine MeSH
- Triglycerides blood MeSH
- Fat Emulsions, Intravenous administration & dosage pharmacology MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Glycated Hemoglobin A MeSH
- Inulin MeSH
- Blood Glucose MeSH
- p-Aminohippuric Acid MeSH
- Fatty Acids, Nonesterified MeSH
- Lithium MeSH
- Sodium MeSH
- Triglycerides MeSH
- Fat Emulsions, Intravenous MeSH
To evaluate the role of insulin and hypertriglyceridaemia in the regulation of renal haemodynamics and sodium handling in insulin-dependent diabetes mellitus (IDDM), 11 IDDM patients without microalbuminuria and 13 weight-, age-, protein intake- and sex-matched healthy control subjects were studied. Clearances of inulin (Cin), para-amino-hippuric acid (CPAH), sodium (CNa), and lithium (CLi) were measured in four 60-min clearance periods (periods I, II, III and IV) during isoinsulinaemia with lipid emulsion infusion (study 1), a hyperinsulinaemic isoglycaemic clamp with Intralipid infusion (study 2), and during time-controlled isoinsulinaemia (study 3). We found that Cin, CPAH and filtration fraction were comparable in IDDM and control subjects, whereas CNa was decreased in diabetic subjects (2.01 +/- 1.11 vs 3.03 +/- 1.32 ml/min; p < 0.05) due to elevations of proximal tubular fractional and absolute reabsorptions of sodium (p < 0.05). Insulin infusion did not affect Cin, increased CPAH (p < 0.05) and, consequently, lowered the filtration fraction (p < 0.01) in both groups. While acute hyperinsulinaemia resulted in increases in distal tubular fractional and absolute reabsorptions of sodium (p < 0.01) contributing to a fall in CNa (p < 0.01) in control subjects, in diabetic subjects the sodium-retaining effect of insulin was not significant. The lipid emulsion did not alter any of the estimated parameters. We conclude that IDDM without microalbuminuria is associated with a tendency to sodium retention which is not aggravated by insulin when compared to control subjects. Acutely induced hypertriglyceridaemia does not alter renal haemodynamics or renal sodium handling.
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