Spellman Michael J, Assaf Tala, Nangia Shivani, Fernandez Joel, Nicholson Kyle C, Shepard Blythe D
Department of Human Science, Georgetown University, Washington, District of Columbia, United States.
Am J Physiol Renal Physiol. 2024 Dec 1;327(6):F1013-F1025. doi: 10.1152/ajprenal.00265.2024. Epub 2024 Oct 24.
Blood glucose homeostasis is critical to ensure the proper functioning of the human body. Through the processes of filtration, reabsorption, secretion, and metabolism, much of this task falls to the kidneys. With a rise in glucose and other added sugars, there is an increased burden on this organ, mainly the proximal tubule, which is responsible for all glucose reabsorption. In this review, we focus on the current physiological and cell biological functions of the renal proximal tubule as it works to reabsorb and metabolize glucose and fructose. We also highlight the physiological adaptations that occur within the proximal tubule as sugar levels rise under pathophysiological conditions including diabetes. This includes the detrimental impacts of an excess glucose load that leads to glucotoxicity. Finally, we explore some of the emerging therapeutics that modulate renal glucose handling and the systemic protection that can be realized by targeting the reabsorptive properties of the kidney.
血糖稳态对于确保人体正常运作至关重要。通过过滤、重吸收、分泌和代谢过程，这项任务的很大一部分落在了肾脏身上。随着葡萄糖和其他添加糖的增加，该器官（主要是负责所有葡萄糖重吸收的近端小管）的负担也会加重。在这篇综述中，我们重点关注肾近端小管当前的生理和细胞生物学功能，因为它负责重吸收和代谢葡萄糖及果糖。我们还强调了在病理生理条件（包括糖尿病）下糖水平升高时近端小管内发生的生理适应性变化。这包括过量葡萄糖负荷导致糖毒性的有害影响。最后，我们探讨了一些调节肾脏葡萄糖处理的新兴疗法，以及通过靶向肾脏的重吸收特性可实现的全身保护作用。
