© 1997 by European Society of Cardiology
Copyright © 1997, European Society of Cardiology
Volume reflex in diabetes
Department of Physiology and Biophysics, University of Nebraska Medical Center, 600 South 42nd Street, Box 984575, Omaha, NE 68198-4575, USA
* Tel. +1 402 559-8369; Fax +1 402 559-4438.
Received 19 September 1996; accepted 9 December 1996
KEYWORDS Diabetes; Volume reflex; Renal hemodynamics; Autonomic nervous system
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1 Introduction |
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Diabetes mellitus is characterized by altered fluid balance, blood volume and exchangeable sodium. In metabolically stable diabetes there is an increased exchangeable sodium content (10–15%). This occurs in diabetic subjects that are normotensive or hypertensive and those with or without complications [15, 20, 48, 73]. Many of the studies on exchangeable sodium and studies in diabetics of short duration without complications suggest that sodium retention occurs early in the disease and may be relatively common [15, 20, 48, 73]. It has been suggested that the diabetics that develop nephropathy are those who are unable to compensate for this sodium retention. With the kidney disease deteriorating with time the final outcome is often the development of hypertension. These facts, taken together, indicate that the regulation of fluid balance, particularly sodium handling, early during diabetes is of great importance in the overall long-term cardiovascular complications of the diabetic
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2 Evidence for altered volume reflex in the early stage of diabetes |
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2.1 Reduced renal responses to acute saline load in obese Zucker rats (Type II model of diabetes)
2.2 Afferent limb of the volume receptor reflex
2.3 Central sites of integration for the volume receptor reflex
2.4 Efferent limb of the volume receptor reflex
2.4.1 Neural component
2.4.2 Humoral component
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3 Intrarenal factors involved in renal excretory responses produced by acute volume expansion |
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4 Summary |
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