Once the end stage kidney disease has been established, carbohydrate metabolism may be vulnerable for may alterations. Loss of insulin sensitivity

Carbohydrate and insulin metabolism in chronic kidney disease

 

Once the end stage kidney disease has been established, carbohydrate metabolism may be vulnerable for may alterations. Loss of tissue sensitivity to insulin is a fundamental error, however, disturbed insulin secretion and metabolism also have sharing role. Normally, the kidney plays a crucial role in insulin metabolism. Insulin filtration underwent freely via the kidney. Inside the renal tissues, 60% of the total insulin filtration occurs via the kidney glomeruli and 40% could be extracted through the peri-tubular vessels.

NORMAL RENAL HANDLING OF INSULIN

A given mw (molecular weight) of 6000 may permit the free insulin filtration by the kidney. Insulin can have degraded into amino acids inside the proximal renal tubules. Currently, lower than one % of the cleared insulin can present in urine. As renal insulin filtration is about 200 mL/min, that evidently exceeding the natural glomerular filtration rate (GFR) of 120 mL/min. These figures mean that daily metabolism of insulin is about 6-8 units that can be metabolized by the kidney which equals one quarter of the daily pancreatic production.