Skip to main content
Log in

Renal glycosuria in patients with the nephrotic syndrome

  • Originalien
  • Published:
Klinische Wochenschrift Aims and scope Submit manuscript

Summary

Transient or persistent renal glycosuria may occur in patients with the nephrotic syndrome. In an attempt to elucidate its mechanism, glucose titration experiments were performed in 20 nephrotic patients. The type A titration curve was found in one and type B in four patients with severe organic changes and low glomerular filtration rate. The remaining subjects displayed a particular type of curve (type C) characterized by a low point of splay but an otherwise almost physiological tracing. In type B and C patients the maximal rate of reabsorption per ml glomerular filtrate (TmG/GFR) was significantly increased and correlated inversely with the filtration fraction. In these patients the point of splay correlated with the glomerular filtration rate and the sodium clearance, but not with the plasma albumin concentration or the rate of proteinuria. These observations suggest that type A was due to diffuse tubular atrophy, and type B to increased nephron heterogeneity resulting from chronic organic changes. Type C was presumably caused by a potentially reversible alteration of the late proximal or distal glucose transport related to the nephrotic syndrome itself.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Arruda JAL, Gutierrez LF, Kurtzman NA (1975) Diuretic agents and glucose reabsorption. Proc Soc Exp Biol Med 149:50–55

    Google Scholar 

  2. Barfuss DW, Schafer JA (1981) Differences in active and passive glucose transport along the proximal nephron. Am J Physiol 241:F322-F332

    Google Scholar 

  3. Berry CA, Cogan MG (1981) Influence of peritubular protein on solute absorption in the rabbit proximal tubule. J Clin Invest 68:506–516

    Google Scholar 

  4. Boonjarern S, Laski ME, Kurtzman NA (1976) Effects of extracellular volume expansion on the tubular reabsorption of glucose. Pfluegers Arch 366:67–71

    Google Scholar 

  5. Elsas LJ, Rosenberg LE (1969) Familial renal glycosuria: a genetic reappraisal of hexose transport by kidney and intestine. J Clin Invest 48:1845–1854

    Google Scholar 

  6. Froesch ER, Renold AE (1956) Specific enzymatic determination of glucose in blood and urine using glucose oxidase. Diabetes 5:1–5

    Google Scholar 

  7. Froesch ER, Winegrad AI, Renold AE, Thorn GW (1958) Mechanism of the glucosuria produced by the administration of steroids with glucocorticoid activity. J Clin Invest 37:524–532

    Google Scholar 

  8. Gluck MC, Gallo G, Lowenstein J, Baldwin DS (1973) Membranous glomerulonephritis. Ann Intern Med 78:1–12

    Google Scholar 

  9. Govaerts P, Lambert PP (1949) Pathogénie du diabète rénal. Acta Clin Belg 4:341–371

    Google Scholar 

  10. Heptinstall RH (1974) Pathology of the kidney. 2nd edition. Little, Brown & Co, Boston, 399–402

    Google Scholar 

  11. Higgins JT, Meinders AE (1975) Quantitative relationship of renal glucose and sodium reabsorption during ECF expansion. Am J Physiol 229:66–71

    Google Scholar 

  12. Keller DM (1968) Glucose excretion in man and dog. Nephron 5:43–66

    Google Scholar 

  13. Kramp RA, Lorentz WB (1982) Glucose transport in chronically altered rat nephrons. Am J Physiol 243:F393-F403

    Google Scholar 

  14. Kurtzman NA, White MG, Rogers PW, Flynn JJ (1972) Relationship of sodium reabsorption and glomerular filtration to renal glucose reabsorption. J Clin Invest 51:127–133

    Google Scholar 

  15. McPhaul JJ, Simonaitis JJ (1968) Observations on the mechanisms of glucosuria during glucose loads in normal and nondiabetic subjects. J Clin Invest 47:702–711

    Google Scholar 

  16. Oliver J, McDowell M (1961) The structural and functional aspects of the handling of glucose by the nephrons and the kidney and their correlation by means of structural-functional equivalents. J Clin Invest 40:1093–1112

    Google Scholar 

  17. Renschler H (1965) Der Einfluß der Nierenfunktion auf die Glukoseausscheidung Gesunder. Boehringer & Söhne, Mannheim

    Google Scholar 

  18. Reubi FC (1954) Glucose titration in renal glycosuria. In: The Kidney. A Ciba Foundation symposium. J ⇐p; A Churchill, London, 96–106

    Google Scholar 

  19. Reubi FC (1963) Clearance tests in clinical medicine. CC Thomas, Springfield, Ill

    Google Scholar 

  20. Reubi FC, Weidmann P, Glück Z (1979) Interrelationships between sodium clearance, plasma aldosterone, plasma renin activity, renal hemodynamics and blood pressure in renal disease. Klin Wochenschr 57:1273–1285

    Google Scholar 

  21. Richterich R, Küffer H, Lorenz E, Colombo JP (1974) Die Bestimmung der Glucose in Plasma und Serum (Hexokinase/Glucose-6-Phosphat-Dehydrogenase-Methode) mit dem Greiner Electronic Selective Analyzer GSA II. Z Klin Chem Klin Biochem 12:5–13

    Google Scholar 

  22. Rieselbach RE, Shankel SW, Slatopolsky E, Lobowitz H, Bricker NS (1967) Glucose titration studies in patients with chronic progressive renal disease. J Clin Invest 46:157–163

    Google Scholar 

  23. Robson AM, Srivastava PL, Bricker NS (1968) The influence of saline loading on renal glucose reabsorption in the rat. J Clin Invest 47:329–335

    Google Scholar 

  24. Rohde R, Deetjen P (1968) Glucose reabsorption in the rat kidney. Pfluegers Arch 302:219–232

    Google Scholar 

  25. Schafer JA, Barfuss DW (1982) The study of pars recta function by the perfusion of isolated tubule segments. Kidney Int 22:434–448

    Google Scholar 

  26. Schmidt RW, Danovitch GM (1979) Glucose reabsorption in experimental renal insufficiency: effects of proportional reduction of sodium intake. Kidney Int 16:590–599

    Google Scholar 

  27. Schubert GE, Schuster HP, Baum P (1964) Physiologische Glukosurie bei verschiedenen Diuresezuständen. Klin Wochenschr 42:619–622

    Google Scholar 

  28. Shannon JA (1939) Renal tubular excretion. Physiol Review 19:63–93

    Google Scholar 

  29. Smith HW (1943) Lectures on the kidney. University of Kansas, Lawrence, Kansas

    Google Scholar 

  30. Tune BM, Burg MB (1971) Glucose transport by proximal renal tubules. Am J Physiol 221:580–585

    Google Scholar 

  31. Turner RJ, Moran A (1982) Heterogeneity of sodium dependent D-glucose transport sites along the proximal tubule: evidence from vesicle studies. Am J Physiol 242:F406-F414

    Google Scholar 

  32. Usberti M, Frederico S, Cianciaruso B, Costanzo R, Russo D, Andreucci VE (1979) Relationship between serum albumin concentration and tubular reabsorption of glucose in renal disease. Kidney Int 16:546–551

    Google Scholar 

  33. Vorburger C, Riedwyl H, Reubi FC (1969) Vergleichende Studien zwischen den renalen Clearances von51Cr-EDTA, Inulin und Natriumthiosulfat beim Menschen. Klin Wochenschr 47:415–420

    Google Scholar 

  34. Wen SF, Stoll RW (1979) Effect of volume expansion on renal glucose transport in normal and uremic dogs. Am J Physiol 236:F567-F574

    Google Scholar 

  35. Woolf LI, Goodwin BL, Phelps CE (1966) Tm-limited renal tubular reabsorption and the genetics of renal glucosuria. J Theor Biol 11:10–21

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reubi, F.C., Seiler, A. & Farina, K. Renal glycosuria in patients with the nephrotic syndrome. Klin Wochenschr 62, 621–630 (1984). https://doi.org/10.1007/BF01721917

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01721917

Key words

Navigation