Author(s): Pina, Ana F. ; Borges, Diego O. ; Meneses, Maria João ; Branco, Patrícia ; Birne, Rita ; Vilasi, Antonio ; Macedo, Maria Paula
Date: 2020
Persistent ID: http://hdl.handle.net/10362/108168
Origin: Repositório Institucional da UNL
Subject(s): albuminuria; diabetic nephropathy; insulin; insulin clearance; insulin resistance; Developmental Biology; Cell Biology; SDG 3 - Good Health and Well-being; SDG 7 - Affordable and Clean Energy
This work was supported by “Fundação para a Ciência e a Tecnologia” – FCT to AP (PD/BD/136887/2018); MJM (PD/BD/114256/2016), MPM (PTDC/DTP-EPI/0207/2012), DOB e MPM (PTDC/BIM-MET/2115/2014); iNOVA4Health (UIDB/Multi/04462/2020), by the European Commission Marie Skłodowska -Curie Actions H2020 (grant agreements nos. 722619 and 734719), and by the Sociedade Portuguesa de Diabetologia.
Kidney function in metabolism is often underestimated. Although the word “clearance” is associated to “degradation”, at nephron level, proper balance between what is truly degraded and what is redirected to de novo utilization is crucial for the maintenance of electrolytic and acid–basic balance and energy conservation. Insulin is probably one of the best examples of how diverse and heterogeneous kidney response can be. Kidney has a primary role in the degradation of insulin released in the bloodstream, but it is also incredibly susceptible to insulin action throughout the nephron. Fluctuations in insulin levels during fast and fed state add another layer of complexity in the understanding of kidney fine-tuning. This review aims at revisiting renal insulin actions and clearance and to address the association of kidney dysmetabolism with hyperinsulinemia and insulin resistance, both highly prevalent phenomena in modern society.
