Pyruvate and Lactate Excretion in Diabetes
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چکیده
Anderson and Marks (1962) showed that the reabsorption of pyruvate in the kidney tubules of normal subjects is nearly complete. In diabetics, while the plasma concentration of pyruvate may be twice that of normal subjects, the urinary excretion of pyruvate is usually three or four times greater (Takanami et al., 1960 ; Anderson and Mazza, 1963 ; Anderson et al., 1964). Thus the reabsorptive capacity for pyruvate in the diabetic may be reaching a maximum. In normal subjects almost complete reabsorption of lactate occurs. In diabetic patients, while the plasma lactate concentration may be nearly 50% higher, the urinary excretion is doubled or trebled. The renal clearance of lactate is thus increased in diabetics. With cystinuria as an example, where there is a common defect in the reabsorption of the amino-acids cystine, lysine, arginine, and ornithine, an increased concentration in the blood of one amino-acid increases the excretion of the others, since they share a common reabsorptive mechanism. As it appeared that pyruvate and lactate might also share a common tubular reabsorptive mechanism, the renal lactate load was raised by giving 10 g. of neutral D-L-sodium lactate by mouth to try to increase the excretion of pyruvate in diabetic patients.
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تاریخ انتشار 2007