| Autor: |
Nistor M; Orthopaedic Department, Jena University Hospital, Campus Eisenberg, 07607 Eisenberg, Germany., Schmidt M; Institute for Biochemistry II, Jena University Hospital, 07743 Jena, Germany., Klingner C; Department of Neurology, Jena University Hospital, 07747 Jena, Germany., Klingner C; Department of Neurology, Jena University Hospital, 07747 Jena, Germany., Schwab M; Department of Neurology, Jena University Hospital, 07747 Jena, Germany., Bischoff SJ; Institute for Laboratory Animals and Welfare, Jena University Hospital, 07743 Jena, Germany., Matziolis G; Orthopaedic Department, Jena University Hospital, Campus Eisenberg, 07607 Eisenberg, Germany., Rodríguez-González GL; Reproductive Biology, National Institute of Medical Science and Nutrition, 14080 Mexico City, Mexico., Schiffner R; Orthopaedic Department, Jena University Hospital, Campus Eisenberg, 07607 Eisenberg, Germany.; Emergency Department, Otto-von-Guericke University, 39120 Magdeburg, Germany.; Emergency Department, Helios University Clinic Wuppertal, 42283 Wuppertal, Germany. |
| Abstrakt: |
Previously, we demonstrated in pigs that renal denervation halves glucose release during hypoglycaemia and that a prenatal dexamethasone injection caused increased ACTH and cortisol concentrations as markers of a heightened hypothalamic pituitary adrenal axis (HPAA) during hypoglycaemia. In this study, we investigated the influence of an altered HPAA on renal glucose release during hypoglycaemia. Pigs whose mothers had received two late-gestational dexamethasone injections were subjected to a 75 min hyperinsulinaemic-hypoglycaemic clamp (<3 mmol/L) after unilateral surgical denervation. Para-aminohippurate (PAH) clearance, inulin, sodium excretion and arterio-venous blood glucose difference were measured every fifteen minutes. The statistical analysis was performed with a Wilcoxon signed-rank test. PAH, inulin, the calculated glomerular filtration rate and plasma flow did not change through renal denervation. Urinary sodium excretion increased significantly ( p = 0.019). Side-dependent renal net glucose release (SGN) decreased by 25 ± 23% ( p = 0.004). At 25 percent, the SGN decrease was only half of that observed in non-HPAA-altered animals in our prior investigation. The current findings may suggest that specimens with an elevated HPAA undergo long-term adaptations to maintain glucose homeostasis. Nonetheless, the decrease in SGN warrants further investigations and potentially caution in performing renal denervation in certain patient groups, such as diabetics at risk of hypoglycaemia. |
