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Articles in PresS, published online ahead of print December 21, 2001
Am J Physiol Regu Physiol, 10.1152/ajpregu.00610.2001
Submitted on October 10, 2001
Accepted on December 7, 2001
1 Medicine, University of California, San Diego, CA, none
2 Medicine, University of California, San Diego, CA, none; Medicine, Veterans Affairs Medical Center, San Diego, CA, none
* To whom correspondence should be addressed. E-mail: sthomson{at}popmail.ucsd.edu.
GFR normally increases during glycine infusion, which is a test of "renal reserve." Renal reserve is absent in diabetes mellitus. GFR increases after protein feeding due to increased tubular reabsorption which reduces the signal for tubuloglomerular feedback (TGF). Dietary protein restriction normalizes some aspects of glomerular function in diabetes. Renal micropuncture was performed in rats with 4-5 weeks of streptozotocin diabetes to determine whether renal reserve is lost due to altered tubular function and activation of TGF, whether ten days of dietary protein restriction could restore renal reserve and whether this results from effects of glycine on the tubule. TGF activation was determined by locating single nephron GFR (SNGFRd) along the TGF curve. The TGF signal was determined from the ionic content of the early distal tubule. In nondiabetics, SNGFRd increased during glycine due to primary vasodilation augmented by increased tubular reabsorption which stabilized the TGF signal. In diabetics, glycine reduced reabsorption, thereby activating TGF which was largely responsible for the lack of renal reserve. In protein restricted diabetics, the tubular response to glycine remained abnormal, but renal reserve was restored by a vascular mechanism. Glycine affects GFR directly and via the tubule. In diabetes reduced tubular reabsorption dominates. In low protein diabetes, the vascular effect is enhanced and overrides the effect of reduced tubular reabsorption.
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