Effect of Renal Disease on Renal Uptake and Excretion of Insulin in Man

Abstract

Renal handling of insulin was studied over plasma insulin levels of 6 to 40 μU per milliliter in 13 patients by renal-vein catheterization. The kidney in normal subjects and 7 patients with moderate renal insufficiency — glomerular filtration rate (GFR) over 22.5 ml per minute per kidney per 1.73 M² — removed 39 ± 4 per cent (SD) of the insulin from arterial plasma. Severe renal insufficiency (GFR less than 6) reduced insulin uptake to 9 per cent in four subjects, two with diabetic glomerulosclerosis. Mean GFR in normal subjects was 61 ± 11 (SD) and renal insulin extraction —renal plasma flow (RPF) × % uptake — was 106 ± 28 (SD).