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2015 ; 3
(11
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Renal glucose release during hypoglycemia is partly controlled by sympathetic
nerves - a study in pigs with unilateral surgically denervated kidneys
#MMPMID26564063
Bischoff SJ
; Schmidt M
; Lehmann T
; Schwab M
; Matziolis G
; Saemann A
; Schiffner R
Physiol Rep
2015[Nov]; 3
(11
): ä PMID26564063
show ga
Catecholamines are known to increase renal glucose release during hypoglycemia.
The specific extent of the contribution of different sources of catecholamines,
endocrine delivery via circulation or release from autonomous sympathetic renal
nerves, though, is unknown. We tested the hypothesis that sympathetic renal
innervation plays a major role in the regulation of renal gluconeogenesis. For
this purpose, instrumented adolescent pigs had one kidney surgically denervated
while the other kidney served as a control. A hypoglycemic clamp with arterial
blood glucose below 2 mmol/L was maintained for 75 min. Arteriovenous blood
glucose difference, inulin clearance, p-aminohippurate clearance, and sodium
excretion were measured in intervals of 15 min separately for both kidneys. Blood
glucose was lowered to 0.84 ± 0.33 mmol/L for 75 min. The side-dependent renal
net glucose release (SGN) decreased significantly after the unilateral ablation
of renal nerves. In the linear mixed model, renal denervation had a significant
inhibitory effect on renal net glucose release (P = 0.036). The SGN of the
ablated kidney decreased by 0.02 mmol/min and was equivalent to 43.3 ± 23.2% of
the control (nonablated) kidney in the pigs. This allows the conclusion that
renal glucose release is partly controlled by sympathetic nerves. This may be
relevant in humans as well, and could explain the increased risk of severe
hypoglycemia of patients with diabetes mellitus and autonomous neuropathy. The
effects of denervation on renal glucose metabolism should be critically taken
into account when considering renal denervation as a therapy in diabetic
patients.