Glucagon-Like Peptide-1 Receptors in the Kidney: Impact on renal autoregulation
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Glucagon-like peptide-1 (GLP-1) and strategies based on this blood sugar-reducing and appetite-suppressing hormone are used to treat obesity and type-2 diabetes. However, the GLP-1 receptor (GLP-1R) is also present in the kidney where it influences renal function. The effect of GLP-1 on the kidney varies between humans and rodents. The effect of GLP-1 on kidney function also seems to vary depending on its concentration and the physiological or pathological state of the kidney. In studies with rodents or humans, acute infusion of pharmacological doses of GLP-1 stimulates natriuresis and diuresis. However, the effect on the renal vasculature is less clear. In rodents, GLP-1 infusion increases renal plasma flow (RPF) and glomerular filtration rate (GFR), suggesting renal vasodilation. In humans, only a subset of the subjects exhibits increased RPF and GFR. Differential status of kidney function and changes renal vascular resistance of the preglomerular arterioles, may account for the different responses of the human subjects. Because renal function in type-2 diabetic patients is already at risk or compromised, understanding the effects of GLP-1R activation on kidney function in these patients is particularly important. This review examines the distribution of GLP-1R in the kidney and the effects elicited by GLP-1 or GLP-1R agonists. By integrating results from acute and chronic studies in healthy individuals and type-2 diabetic patients along with those from rodent studies, we provide insight into how GLP-1R activation affects renal function and autoregulation.
|Tidsskrift||American Journal of Physiology: Renal Physiology|
|Status||E-pub ahead of print - 16 dec. 2019|