Skip to main content
NCBI home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1974 Mar;53(3):841–847. doi: 10.1172/JCI107624

Hyperglucagonemia of Renal Failure

Gordon L Bilbrey 1,2, Gerald R Faloona 1,2, Martin G White 1,2, James P Knochel 1,2, Julio Borroto 1,2
PMCID: PMC333066  PMID: 4812442

Abstract

Elevation of plasma glucagon concentration has been observed in starvation and illnesses associated with increased catabolism such as diabetes mellitus and severe infections. Thus, we examined plasma glucose, immunoreactive insulin (IRI, microunits per milliliter) and glucagon (IRG, picograms per milliliter) responses to a beef meal (1 g/kg body wt) and intravenous glucose (1.5 g/min for 45 min) in patients with chronic renal failure (CRF).

After the beef meal (n = 6), plasma glucose did not change, IRI rose from 10.1±1.2 to 16.3±1.1 (P < 0.01), and IRG rose from a fasting value of 225±26 to 321±40 (P < 0.01) by 90 min (mean±SEM).

Intravenous infusion of glucose in CRF patients resulted in significant elevations and prolonged disappearance of plasma glucose and insulin when compared to control subjects (P < 0.01). Glucose infusion failed to suppress elevated plasma glucagon concentrations to normal levels.

6 wk of chronic hemodialysis in five patients resulted in normal plasma glucose and insulin responses to the same intravenous glucose load. In contrast, plasma glucagon concentration remained unchanged after hemodialysis and there was no correlation of plasma glucagon levels with carbohydrate intolerance.

Full text

PDF
841

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aguilar-Parada E., Eisentraut A. M., Unger R. H. Effects of starvation on plasma pancreatic glucagon in normal man. Diabetes. 1969 Nov;18(11):717–723. doi: 10.2337/diab.18.11.717. [DOI] [PubMed] [Google Scholar]
  2. Alleyne G. A., Fraser H. S., Besterman H. S. Some effects of metabolic acidosis on carbohydrate metabolism in the rat. Clin Sci. 1970 Sep;39(3):375–382. doi: 10.1042/cs0390375. [DOI] [PubMed] [Google Scholar]
  3. Balestri P. L., Rindi P., Biagini M., Giovannetti S. Effects of uraemic serum, urea, creatinine and methylguanidine on glucose metabolism. Clin Sci. 1972 Apr;42(4):395–404. doi: 10.1042/cs0420395. [DOI] [PubMed] [Google Scholar]
  4. Bilbrey G. L., Carter N. W., White M. G., Schilling J. F., Knochel J. P. Potassium deficiency in chronic renal failure. Kidney Int. 1973 Dec;4(6):423–430. doi: 10.1038/ki.1973.138. [DOI] [PubMed] [Google Scholar]
  5. Briggs J. D., Buchanan K. D., Luke R. G., McKiddie M. T. Role of insulin in glucose intolerance in uraemia. Lancet. 1967 Mar 4;1(7488):462–464. doi: 10.1016/s0140-6736(67)91089-6. [DOI] [PubMed] [Google Scholar]
  6. Cerletty J. M., Engbring N. H. Azotemia and glucose intolerance. Ann Intern Med. 1967 Jun;66(6):1097–1108. doi: 10.7326/0003-4819-66-6-1097. [DOI] [PubMed] [Google Scholar]
  7. Cohen B. D., Horowitz H. I. Carbohydrate metabolism in uremia: inhibition of phosphate release. Am J Clin Nutr. 1968 May;21(5):407–413. doi: 10.1093/ajcn/21.5.407. [DOI] [PubMed] [Google Scholar]
  8. GLICK S. M., ROTH J., YALOW R. S., BERSON S. A. THE REGULATION OF GROWTH HORMONE SECRETION. Recent Prog Horm Res. 1965;21:241–283. [PubMed] [Google Scholar]
  9. Ghavamian M., Gutch C. F., Kopp K. F., Kolff W. J. The sad truth about hemodialysis in diabetic nephropathy. JAMA. 1972 Dec 11;222(11):1386–1389. [PubMed] [Google Scholar]
  10. Hampers C. L., Soeldner J. S., Doak P. B., Merrill J. P. Effect of chronic renal failure and hemodialysis on carbohydrate metabolism. J Clin Invest. 1966 Nov;45(11):1719–1731. doi: 10.1172/JCI105478. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Horton E. S., Johnson C., Lebovitz H. E. Carbohydrate metabolism in uremia. Ann Intern Med. 1968 Jan;68(1):63–74. doi: 10.7326/0003-4819-68-1-63. [DOI] [PubMed] [Google Scholar]
  12. Lindall A., Carmena R., Cohen S., Comty C. Insulin hypersecretion in patients on chronic hemodialysis. Role of parathyroids. J Clin Endocrinol Metab. 1971 May;32(5):653–658. doi: 10.1210/jcem-32-5-653. [DOI] [PubMed] [Google Scholar]
  13. Lowrie E. G., Soeldner J. S., Hampers C. L., Merrill J. P. Glucose metabolism and insulin secretion in uremic, prediabetic, and normal subjects. J Lab Clin Med. 1970 Oct;76(4):603–615. [PubMed] [Google Scholar]
  14. Müller W. A., Faloona G. R., Aguilar-Parada E., Unger R. H. Abnormal alpha-cell function in diabetes. Response to carbohydrate and protein ingestion. N Engl J Med. 1970 Jul 16;283(3):109–115. doi: 10.1056/NEJM197007162830301. [DOI] [PubMed] [Google Scholar]
  15. Müller W. A., Faloona G. R., Unger R. H. Hyperglucagonemia in diabetic ketoacidosis. Its prevalence and significance. Am J Med. 1973 Jan;54(1):52–57. doi: 10.1016/0002-9343(73)90083-1. [DOI] [PubMed] [Google Scholar]
  16. Orskov H., Christensen N. J. Growth hormone in uremia. I. Plasma growth hormone, insulin and glucagon after oral and intravenous glucose in uremic subjects. Scand J Clin Lab Invest. 1971 Feb;27(1):51–60. doi: 10.3109/00365517109080189. [DOI] [PubMed] [Google Scholar]
  17. PERKOFF G. T., THOMAS C. L., NEWTON J. D., SELLMAN J. C., TYLER F. H. Mechanism of impaired glucose tolerance in uremia and experimental hyperazotemia. Diabetes. 1958 Sep-Oct;7(5):375–383. doi: 10.2337/diab.7.5.375. [DOI] [PubMed] [Google Scholar]
  18. Rocha D. M., Santeusanio F., Faloona G. R., Unger R. H. Abnormal pancreatic alpha-cell function in bacterial infections. N Engl J Med. 1973 Apr 5;288(14):700–703. doi: 10.1056/NEJM197304052881402. [DOI] [PubMed] [Google Scholar]
  19. Samaan N. A., Freeman R. M. Growth hormone levels in severe renal failure. Metabolism. 1970 Feb;19(2):102–113. [PubMed] [Google Scholar]
  20. Santeusanio F., Faloona G. R., Knochel J. P., Unger R. H. Evidence for a role of endogenous insulin and glucagon in the regulation of potassium homeostasis. J Lab Clin Med. 1973 Jun;81(6):809–817. [PubMed] [Google Scholar]
  21. Spitz I. M., Rubenstein A. H., Bersohn I., Abrahams C., Lowy C. Carbohydrate metabolism in renal disease. Q J Med. 1970 Apr;39(154):201–226. [PubMed] [Google Scholar]
  22. Spitz I., Rubenstein A. H., Bersohn I., Lawrence A. M., Kirsteins L. The effect of dialysis on the carbohydrate intolerance of chronic renal failure. Horm Metab Res. 1970 Mar;2(2):86–93. doi: 10.1055/s-0028-1095114. [DOI] [PubMed] [Google Scholar]
  23. Unger R. H., Aguilar-Parada E., Müller W. A., Eisentraut A. M. Studies of pancreatic alpha cell function in normal and diabetic subjects. J Clin Invest. 1970 Apr;49(4):837–848. doi: 10.1172/JCI106297. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Unger R. H. Glucagon physiology and pathophysiology. N Engl J Med. 1971 Aug 19;285(8):443–449. doi: 10.1056/NEJM197108192850806. [DOI] [PubMed] [Google Scholar]
  25. WESTERVELT F. B., Jr, SCHREINER G. E. The carbohydrate intolerance of uremic patients. Ann Intern Med. 1962 Aug;57:266–276. doi: 10.7326/0003-4819-57-2-266. [DOI] [PubMed] [Google Scholar]
  26. Westervelt F. B. Insulin effect in uremia. J Lab Clin Med. 1969 Jul;74(1):79–84. [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES