Glomerular Filtration Rate is Increased in Man by the Infusion of Both d,l-3-Hydroxybutyric Acid and Sodium d,l-3-Hydroxybutyrate

A high glomerular filtration rate (GFR) is often found early in insulin-dependent diabetes mellitus (IDDM). It has been suggested that high circulating glucose, glucagon, and GH levels could play a role in this increase in GFR. On the other hand, patients with IDDM in poor metabolic control also have high circulating ketone body levels. This study was undertaken to determine whether exogenous d,l-3-hydroxybutyric acid at two infusion rates (40 and 30 μmol kg−1 min−1) for 180 min altered renal plasma flow (RPF), GFR, and the excretion rate of total protein, β-microglobulin, and albumin in 11 normal (N) subjects and 11 IDDM patients in whom euglycemia was achieved and maintained using the insulin-glucose clamp technique. RPF and GFR were measured by a priming-continuous infusion of [125I]hippurate and [51Cr]EDTA, respectively. The 40 μmol kg−1 min−1 d,l-3-hydroxybutyric acid infusion increased RPF and GFR in both N and IDDM subjects. Mean RPF increased from 588 ± 78 (±SD) to 706 ± 129 mL min−1 1.73 m−2 in N...