Abnormal Carbohydrate Metabolism in Renal Disease

Burton D. Cohen

Annals of Internal Medicine · 1962 · 87 citations · 33 references

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Abstract

Article1 August 1962Abnormal Carbohydrate Metabolism in Renal DiseaseBlood Glucose Unresponsiveness to Hypoglycemia, Epinephrine, and GlucagonBURTON D. COHEN, M.D.BURTON D. COHEN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-57-2-204 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSeveral disease states share with diabetes mellitus a decreased rate of decline of blood glucose manifested by an elevated fasting blood sugar and an abnormal glucose tolerance. These include hepatic cirrhosis (1), malignancy (2, 3), eclampsia (4, 5), renal disease (6, 7), essential hyperlipemia (8), and a variety of endocrine disorders such as Cushing's syndrome, acromegaly, thyrotoxicosis, and pheochromocytoma (9). This paper attempts to define the site of this metabolic defect in patients with renal disease.In 1916 Myers and co-workers (10, 11) observed fasting hyperglycemia in 20 per cent of patients with renal disease. This finding, subsequently confirmed by...References1. HILLMAN RW: Dextrose, insulin and epinephrine tolerance in cirrhosis of the liver. Amer. J. Dig. Dis. 16: 174, 1949. CrossrefMedlineGoogle Scholar2. ROHDENBURGBERNHARDKREHBIEL GLAO: Sugar tolerance in cancer. J. A. M. A. 72: 1528, 1919. CrossrefGoogle Scholar3. WOODWARDFRY GEEG: The hyperglycemia of cancer. Biochem. J. 26: 889, 1932. CrossrefMedlineGoogle Scholar4. STANDERHARRISON HJEP: Carbohydrate metabolism in eclampsia. Amer. J. Obstet. Gynec. 18: 17, 1929. CrossrefGoogle Scholar5. BURT RL: Peripheral utilization of glucose in pregnancy. II. Pre-eclampsia. Obstet. Gynec. (N. Y.) 6: 51, 1955. Google Scholar6. ARNOLDTAVLOVSPARGOBREWER JDARBGJ: Subclinical diabetes mellitus in patients presenting with clinical chronic "glomerulonephritis." Trans. Ass. Amer. Physicians 71: 186, 1958. MedlineGoogle Scholar7. DUNCAN GG: Diseases of Metabolism, W. B. Saunders Company, Philadelphia and London, 1953, p. 820. Google Scholar8. MOSENTHALBARRY HOE: Criteria for and interpretation of normal glucose tolerance tests. Ann. Intern. Med. 33: 1175, 1950. LinkGoogle Scholar9. DE BODOALTSZULER RCN: Insulin hypersensitivity and physiologic insulin antagonists. Physiol. Rev. 38: 389, 1958. CrossrefMedlineGoogle Scholar10. MYERSBAILEY VCCV: The Lewis and Benedict method for the estimation of blood sugar, with some observations obtained in disease. J. Biol. Chem. 24: 147, 1916. CrossrefGoogle Scholar11. MYERSKILLIAN VCJA: Studies on animal diastase. I. The increased diastase activity of the blood in diabetes and nephritis. J. Biol. Chem. 29: 179, 1917. CrossrefGoogle Scholar12. 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POLLACKMILLETESSECMANNBOLLMAN HRFHEFCJL: Serum phosphate changes induced by injections of glucose in dogs under various conditions. Amer. J. Physiol. 110: 117, 1934. CrossrefGoogle Scholar31. SOSKINLEVINEHECHTER SRO: The relation between the phosphate changes in blood and muscle, following dextrose, insulin and epinephrine administration. Ibid. 134: 40, 1941. Google Scholar32. KLEINKLEIN HSP: Spontaneous hypoglycemia associated with massive hepatoma. Arch. Intern. Med. 103: 273, 1959. CrossrefGoogle Scholar33. MACLEANDE WESSELOW HOL: The estimation of sugar tolerance. Quart. J. Med. 14: 103, 1920. Google Scholar34. FOSTER GL: Studies on carbohydrate metabolism. II. An interpretation of the blood sugar phenomena following the ingestion of glucose. J. Biol. Chem. 55: 303, 1923. CrossrefGoogle Scholar35. LANDAULEONARDS BRJR: Significance of changes in blood glucose specific activity following insulin administration. Amer. J. Physiol. 198: 793, 1960. CrossrefMedlineGoogle Scholar36. FORSHAMTHORN PHGW: Changes in inorganic serum phosphorus during the intravenous glucose tolerance test as an adjunct to the diagnosis of early diabetes mellitus. Proc. Amer. Diabetes Ass. 9: 99, 1949. Google Scholar37. DRABKINMARSH DLJB: Metabolic channelling in experimental nephrosis. I. Protein and carbohydrate metabolism. J. Biol. Chem. 212: 623, 1955. CrossrefMedlineGoogle Scholar38. MARKOWITZ J: Glyconeogenesis. Amer. J. Physiol. 74: 22, 1925. CrossrefGoogle Scholar39. VAN ITALLIEBENTLEY TBWB: Glucagon-induced hyperglycemia as an index of liver function. J. Clin. Invest. 34: 1730, 1955. CrossrefMedlineGoogle Scholar40. ZUBRODEVERSOLEDANA CGSLGW: Amelioration of diabetes and striking rarity of acidosis in patients with Kimmelstiel-Wilson lesions. New Engl. J. Med. 245: 518, 1951. CrossrefMedlineGoogle Scholar41. APPELMAN DH: Kimmelstiel-Wilson syndrome. New York J. Med. 60: 1518, 1961. Google Scholar42. RUNYANHURWITZROBBINS JWDSL: Effect of Kimmelstiel-Wilson syndrome on insulin requirements in diabetes. New Engl. J. Med. 252: 388, 1955. CrossrefMedlineGoogle Scholar43. WILSONROOTMARBLE JLHFA: Diabetic nephropathy, a clinical syndrome. Ibid. 245: 513, 1951. Google Scholar44. HATCHPARRISH FEAE: Apparent remission of a severe diabetic on developing the Kimmelstiel-Wilson syndrome. Ann. Intern. Med. 54: 544, 1961. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the Medical Research Service, Veterans Administration Hospital, and the Department of Medicine, Cornell University Medical College, New York, New York.Dr. Cohen is a clinical investigator of the Veterans Administration.Requests for reprints should be addressed to Burton D. Cohen, M.D., The Bronx Hospital, 1276 Fulton Avenue, Bronx 56, New York.*This term should not be confused with "renal glycosuria" which results from a decreased renal threshold for glucose absorption. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByMetabolic Alterations in SARS-CoV-2 Infection and Its Implication in Kidney DysfunctionReversible nephrotic syndrome and renal failure in a patient with diabetesAccelerated glycogenolysis in uremia and under sucrose feeding: role of phosphorylase alpha regulatorsUremia-induced disturbances in hepatic carbohydrate metabolism: Enhancement by sucrose feedingOxalate, a Potential Atherogenic Toxin of Uremia, Inhibits Endothelial Proliferation Induced by Heparin-binding Growth Factors In VitroUremic levels of oxalic acid suppress replication and migration of human endothelial cells.Hypoglycemia Associated with Renal FailureMiddle molecule hypothesis and short dialysisPathogenesis and Consequences of the Alteration of Glucose Metabolism in Renal InsufficiencyBeta-adrenergic contribution to glucagon-induced glucose production and insulin secretion in uremiaThe effects of chronic uremia on glucagon binding and action in isolated rat hepatocytesGlucagon DeficiencyGlucagon and Renal InsufficiencyPlasma adenosine 3′:5′ — cyclic monophosphate response to glucagon in uremiaRole of glucagon as a contributor to glucose intolerance in acute and chronic uremiaGuanidinosuccinic Acid and the Alternate Urea CycleStudies on the role of the liver and splanchnic tissues in the production of carbohydrate intolerance in uremiaRENIN-ANGIOTENSIN MEDIATION OF ADRENAL CATECHOLAMINE SECRETION INDUCED BY HYPOGLYCAEMIA IN THE CATPattern of growth hormone response to insulin, arginine and haemodialysis in uraemic childrenEndocrine Abnormalities Associated With Chronic Renal FailureGlucose intolerance in uremia (A- and B-cell function during conservative and dialytic management)Possible sites of interaction of acute renal failure with amino acid utilization for gluconeogenesis in isolated perfused rat liverDiabetes und NierenHemodiafiltrationThe influence of chronic uremia on hepatic glycogen in the ratCarbohydrate metabolism in the chronically uremic ratRole of the kidneys in hyperglycemia provoked by anti-insulin serum in ratsPathobiochemie und Pathophysiologie der chronischen NiereninsuffizienzHepatische Galaktose-Eliminationskapazit�t bei chronischer NiereninsuffizienzChanges in glucose tolerance, insulin, serum lipids and lipoproteins in patients with renal failure on intermittent haemodialysisEnhanced response to tolbutamide in uremiaUntersuchungen �ber Speicherkapazit�t und Transportmaximum der Leber f�r Bromsulphthalein bei chronischer NiereninsuffizienzAbnormal carbohydrate metabolism in uraemiaMetabolic Abnormalities in UremiaGrowth Hormone in Uremia I. Plasma Growth Hormone, Insulin and Glucagon after Oral and Intravenous Glucose in Uremic SubjectsUremiaMetabolism of xylitol in healthy subjects and patients with renal diseaseGlucagonLack of dialyzable insulin antagonist in uremiaGlucose intolerance in uraemiaBLOOD LEVELS OF INSULIN IN URAEMIC PATIENTSSubstrat- und Sauerstoffaufnahme des Herzmuskels bei UrämieThe Renal Excretion of Nitrogen Containing MetabolitesHypertriglyceridemiaLiver glycogen concentration in patients with chronic uremiaMedical management of chronic renal failureThe effect of prolonged starvation on blood glucose and plasma free fatty acids in nephrectomized rats with acute uremic syndromeCarbohydrate Metabolism in UremiaEDWARD S. HORTON, M.D., CHARLES JOHNSON, M.D., HAROLD E. LEBOVITZ, M.D.Untersuchungen zur urämischen KohlenhydratstoffwechselstörungDie NiereninsuffizienzNiere bei EndokrinopathienThe effect of uremic serum on carbohydrate metabolism in rat diaphragmHyperglycemia and Hyperosmolality Complicating Peritoneal DialysisJAMES BOYER, M.D., GORDON N. GILL, M.D., FRANKLIN H. EPSTEIN, M.D.The effect of potassium on the imparired glucose tolerance in chronic uremiaAzotemia and Glucose IntoleranceJAMES M. CERLETTY, M.D., NORMAN H. ENGBRING, M.D.ROLE OF INSULIN IN GLUCOSE INTOLERANCE IN URÆMIAGlucose Intolerance in Patients on Long-term Intermittent DialysisROGER H. HUTCHINGS, M.D., ROBERT M. HEGSTROM, M.D., BELDING H. SCRIBNER, M.D.The Study of Carbohydrate MetabolismEtude de la glycor�gulation dans l'insuffisance r�nale chronique 1Abnormal carbohydrate metabolism in renal failureInsulin inhibition and antagonismManagement of chronic renal failureConsiderations in the patient with diminished renal functionUntersuchungen zum Kohlenhydratstoffwechsel bei Niereninsuffizienz 1 August 1962Volume 57, Issue 2_Part_1Page: 204-213KeywordsGlucagonGlucoseHospital medicineHyperglycemiaHyperlipidemiaHypoglycemiaInsulinInsulin signalingPheochromocytomaRenal diseases Issue Published: 1 August 1962 PDF DownloadLoading ...

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