The role of the kidney in plasma glucose regulation during hyperglycemia. Cersosimo, Eugenio, Mohamed Ajmal, Rebbeca J. Naukam, Patricia E. Molina, Naji N Abumrad. Departments of Medicine and Surgery, State University of New York at Stony Brook, Stony Brook, NY 11794-8154
APStracts 4:0003E, 1997.
Little is known about the role of the kidney in plasma glucose regulation during hyperglycemia. We studied 12 overnight fasted conscious dogs after either intrarenal (IR, n=6) or peripheral (PH, n=6) dextrose infusion to maintain hyperglycemia without glycosuria. Systemic & renal glucose kinetics were measured with [6-3H] glucose; lactate balance by AV difference; and glycogen content assayed in the kidneys. Plasma glucose (_5.5 vs _6.3 mM); insulin (_70 vs _110 pM); and glucose appearance (_14 vs _16 _mol.kg.-1min-1) increased comparably in both groups (p<0.05). In IR, fractional extraction of glucose (FEg) increased from 4.1+/-0.2% to 16.1+/-0.5% (p<0.001) and lactate balance reversed to renal output (+1.3+/-0.2 vs -0.9+/-0.2 _mol.kg.-1min-1 , p<0.01). Glycogen content was 2-fold higher in the left (127+/-33) than in the right kidney (56+/-11 _g/g tissue, p<0.01). In PH, FEg decreased from 4.9+/-0.6% to 2.2+/-0.3% (p<0.05); renal glucose utilization did not change (_1.3 _mol.kg.-1min-1 ) and glycogen content was equal in both kidneys (_45 _g/g tissue). We conclude that, although, the kidney plays a minor role in plasma glucose disposal in physiologic hyperglycemia, increased glucose uptake, glycogen storage and lactate formation precede glycosuria and may represent important mechanisms by which the kidney contributes to normalization of plasma glucose in diabetes.

Received 8 July 1996; accepted in final form 23 December 1996.
APS Manuscript Number E316-6.
Article publication pending Am. J. Physiol. (Endocrinol. Metab.).
ISSN 1080-4757 Copyright 1997 The American Physiological Society.
Published in APStracts on 21 January 1997