Glucose, Insulin, and the Kidney

  • Miet Schetz
  • Ilse Vanhorebeek
  • Jan Gunst
  • Greet Van den Berghe
Chapter
First Online:

Abstract

Several types of critical illness are associated with hyperglycemia and insulin resistance. This “diabetes of stress” used to be considered an adaptive response, beneficial for survival. This dogma was challenged by two large randomized clinical trials showing that tight glycemic control with intensive insulin therapy improves morbidity and mortality rates in critically ill patients. Improved morbidity rates associated with intensive insulin therapy included a beneficial effect on kidney function. Possible mechanisms for this renoprotective effect include prevention or attenuation of oxidative and nitrosative stress, protection of the endothelium, and reduction of inflammation, mitochondrial damage, and apoptosis.

Keywords

Nitric Oxide Blood Glucose Level Renal Replacement Therapy Acute Kidney Injury Intensive Care Unit Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Notes

Acknowledgement

Supported by the Fund for Scientific Research (FWO), Flanders, Belgium (G.0533.06 and G.085.09), the Research Council of the Katholieke Universiteit Leuven (GOA2007/14), FWO and KULeuven Research Council Postdoctoral Fellowships to I.V., and FWO Research Assistant Fellowship to J.G. GVdB by the University of Leuven receives structural research financing via the Methusalem program, funded by the Flemish Government.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  • Miet Schetz
  • Ilse Vanhorebeek
  • Jan Gunst
  • Greet Van den Berghe
    • 1
  1. 1.Department of Intensive Care MedicineUniversity Hospitals, University of LeuvenLeuvenBelgium

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