2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2006091026v1 18/3/944    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Perlstein, T. S. Articles by Thomas, A. Search for Related Content PubMed PubMed Citation Articles by Perlstein, T. S. Articles by Thomas, A. Related Collections Related Article

Insulin Induces Renal Vasodilation, Increases Plasma Renin Activity, and Sensitizes the Renal Vasculature to Angiotensin Receptor Blockade in Healthy Subjects

Todd S. Perlstein^*,, Marie Gerhard-Herman, Norman K. Hollenberg, Gordon H. Williams^* and Abraham Thomas^*,

^* Division of Endocrinology, Diabetes and Hypertension, and Division of Cardiology, Department of Medicine, and the Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts; and Division of Endocrinology and Metabolism, Henry Ford Hospital, Detroit, Michigan

Address correspondence to: Dr. Todd S. Perlstein, Brigham and Women’s Hospital, Cardiovascular Division, 75 Francis Street, A Building, Boston, MA 02115. Phone: 617-545-7168; Fax: 617-264-5265; E-mail: tperlstein{at}partners.org

Received for publication September 20, 2006. Accepted for publication January 1, 2007.

Insulin stimulates the renin-angiotensin system and induces renal vasodilation. The relationship between these opposing influences of insulin on renal vascular tone has not been explored. A hyperinsulinemic euglycemic clamp and sham insulin clamp each of 270 min duration were performed in 15 healthy individuals during high sodium balance. An angiotensin receptor blocker was administered at time 180 min. Renal plasma flow and plasma renin activity were measured serially. The response to insulin or sham insulin infusion was defined as the change from time 0 to 180 min; the response to angiotensin receptor blockade (ARB) was defined as the change from time 180 to 270 min. Insulin infusion increased plasma renin activity (P < 0.01) and renal plasma flow (P < 0.01); the latter effect plateaued by time 150 min. ARB caused a greater vasodilator response during insulin infusion compared with during sham insulin infusion (P = 0.02). Increasing renin response to insulin predicted blunting of the renal vasodilator response to insulin infusion (R² = 0.36, P = 0.02) and sensitizing of the renal vasodilator response to ARB during insulin infusion (R² = 0.59, P < 0.01). Insulin-induced activation of the renin-angiotensin system modulates insulin-induced renal vasodilation in healthy individuals. Further studies are warranted to address this balance in states of insulin resistance and the possible implications for the association of insulin resistance with risk for chronic kidney disease.

Related Article

This Month’s Highlights
J. Am. Soc. Nephrol. 2007 18: 661-662. [Full Text] [PDF]

This article has been cited by other articles:

				I. H. de Boer, B. Kestenbaum, T. C. Rue, M. W. Steffes, P. A. Cleary, M. E. Molitch, J. M. Lachin, N. S. Weiss, J. D. Brunzell, and for the Diabetes Control and Complications Trial ( Insulin Therapy, Hyperglycemia, and Hypertension in Type 1 Diabetes Mellitus Arch Intern Med, September 22, 2008; 168(17): 1867 - 1873. [Abstract] [Full Text] [PDF]

				X. Ruan, F. Zheng, and Y. Guan PPARs and the kidney in metabolic syndrome Am J Physiol Renal Physiol, May 1, 2008; 294(5): F1032 - F1047. [Abstract] [Full Text] [PDF]

				T. Isakova, O. Gutierrez, A. Shah, L. Castaldo, J. Holmes, H. Lee, and M. Wolf Postprandial Mineral Metabolism and Secondary Hyperparathyroidism in Early CKD J. Am. Soc. Nephrol., March 1, 2008; 19(3): 615 - 623. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673