Roles of Renal Gluconeogenesis and Increased Glucose Utilization in Hemorrhagic and Endotoxic Shock.

The roles of renal gluconeogenesis and glucose utilization in control, hemorrhaged, and endotoxin-injected animals, were investigated using anesthetized, eviscerated, nonnephrectomized and nephrectomized canine models. Results demonstrate an increased glucose utilization in both hemorrhagic and endotoxic shock which was marked after endotoxin. Since blood glucose values dropped more in nephrectomized, hemorrhaged animals, in contrast to the nonnephrectomized, hemorrhaged dogs, the kidneys were assumed to perform a significant gluconeogenic role. The kidneys did not appear to perform a gluconeogenic role in endotoxin shock since blood glucose levels were comparable in eviscerated, endotoxin-treated animals whether nephrectomized or not. Accelerated glucose utilization rates were comparable between the eviscerated, nephrectomized animals and test tube experiments. These data suggest that excessive glucose demand by certain blood components may partially explain the lethal hypoglycemia of endotoxin shock.