-transparent.png){kind=logo}
The effects of insulin on the renal handling of sodium, potassium, calcium, and phosphate were studied in man while maintaining the blood glucose concentration at the fasting level by negative feedback servocontrol of a variable glucose infusion. In studies on six water-loaded normal subjects in a steady state of water diuresis, insulin was administered i.v. to raise the plasma insulin concentration to between 98 and 193 muU/ml and infused at a constant rate of 2 mU/kg body weight per min over a total period of 120 min. The blood glucose concentration was not significantly altered, and there was no change in the filtered load of glucose; glomerular filtration rate (CIN) and renal plasma flow (CPAH) were unchanged. Urinary sodium excretion (UNaV) decreased from 401 plus or minus 46 (SEM) to 213 plus or minus 18 mueq/min during insulin administration, the change becoming significant (P smaller than 0.02) within the 30-60 min collection period. Free water clearance (CH2O) increased from 10.6 plus or minus 0.6 to 13 plus or minus 0.5 ml/min (P smaller than 0.025); osmolar clearance decreased and urine flow was unchanged. There was no change in plasma aldosterone concentration, which was low throughout the studies, and a slight reduction was observed in plasma glucagon concentration. Urinary potassium (UKV) and phosphate (UPV) excretion were also both decreased during insulin administration; UKV decreased from 66 plus or minus 9 to 21 plus or minus 1 mueq/min (P smaller than 0.005), and tupv decreased from 504 plus or minus 93 to 230 plus or minus 43 mug/min (P smaller than 0.01). The change in UKV was associated with a significant reduction in plasma potassium concentration. There was also a statistically significant but small reduction in plasma phosphate concentration which was not considered sufficient alone to account for the large reduction in UPV. Urinary calcium excretion (UCaV) increased from 126 plus or minus 24 to 200 plus or minus 17 mug/min (P smaller than 0.01). These studies demonstrate a reduction in UNaV associated with insulin administration that occurs in the absence of changes in the filtered load of glucose, glomerular filtration rate, renal blood flow, and plasma aldosterone concentration. The effect of insulin on CH2O suggests that insulin's effect on sodium excretion is due to enhancement of sodium reabsorption in the diluting segment of the distal nephron.
R A DeFronzo, and
C R Cooke, and
R Andres, and
G R Faloona, and
P J Davis
January 1987,
Mineral and electrolyte metabolism,
R A DeFronzo, and
C R Cooke, and
R Andres, and
G R Faloona, and
P J Davis
November 1986,
Nihon yakurigaku zasshi. Folia pharmacologica Japonica,
R A DeFronzo, and
C R Cooke, and
R Andres, and
G R Faloona, and
P J Davis
February 1984,
The Journal of experimental zoology,
R A DeFronzo, and
C R Cooke, and
R Andres, and
G R Faloona, and
P J Davis
July 2018,
American journal of physiology. Renal physiology,
R A DeFronzo, and
C R Cooke, and
R Andres, and
G R Faloona, and
P J Davis
November 1972,
Kidney international,
R A DeFronzo, and
C R Cooke, and
R Andres, and
G R Faloona, and
P J Davis
May 1990,
Hypertension (Dallas, Tex. : 1979),
R A DeFronzo, and
C R Cooke, and
R Andres, and
G R Faloona, and
P J Davis
August 1971,
Metabolism: clinical and experimental,
R A DeFronzo, and
C R Cooke, and
R Andres, and
G R Faloona, and
P J Davis
January 1976,
International review of physiology,
R A DeFronzo, and
C R Cooke, and
R Andres, and
G R Faloona, and
P J Davis
October 1980,
Klinische Wochenschrift,
R A DeFronzo, and
C R Cooke, and
R Andres, and
G R Faloona, and
P J Davis
January 1979,
Annual review of physiology,
