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The effect of insulin on renal sodium metabolism. A review with clinical implications.

Ralph A. DeFronzo
- 01 Sep 1981 - 
- Vol. 21, Iss: 3, pp 165-171
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TLDR
Clinical situations are reviewed: sodium wasting in poorly controlled diabetics, natriureis of starvation, anti-natriuresis of refeeding and hypertension of obesity, in which insulin-mediated changes in sodium balance have been shown to play an important pathophysiological role.
Abstract
Data are discussed which demonstrate that insulin plays an important role in sodium metabolism. The primary action of insulin on sodium balance is exerted on the kidney. Increases in plasma insulin concentration within the physiological range stimulate sodium reabsorption by the distal nephron segments and this effect is independent of changes in circulating metabolites or other hormones. Several clinical situations are reviewed: sodium wasting in poorly controlled diabetics, natriuresis of starvation, anti-natriuresis of refeeding and hypertension of obesity, in which insulin-mediated changes in sodium balance have been shown to play an important pathophysiological role.

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References
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Journal ArticleDOI

Glucose clamp technique: a method for quantifying insulin secretion and resistance.

TL;DR: Methods for the quantification of beta-cell sensitivity to glucose (hyperglycemic clamp technique) and of tissue sensitivity to insulin (euglycemic insulin clamp technique] are described.
Journal ArticleDOI

Starvation in man.

TL;DR: In this article, it was shown that decreased levels of active T3 may play a role by sparing otherwise obligated calories by decreasing metabolic needs, but this can be nullified by amino acid or protein supplementation.
Journal ArticleDOI

The effect of insulin on renal handling of sodium, potassium, calcium, and phosphate in man.

TL;DR: The effect of insulin on CH2O suggests that insulin's effect on sodium excretion is due to enhancement of sodium reabsorption in the diluting segment of the distal nephron, and a reduction in UNaV associated with insulin administration is demonstrated.
Journal ArticleDOI

The relation of adiposity to blood pressure and development of hypertension. The Framingham study.

TL;DR: The existence of a relationship between hypertension and excess body weight has long been recognized but this relationship has been demonstrated largely in cross-sectional studies obser...
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Effect of weight loss without salt restriction on the reduction of blood pressure in overweight hypertensive patients.

TL;DR: The weight and blood-pressure reductions were highly significant, were present in both sexes and all ages, and were directly associated with antihypertensive-drug therapy.
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