Carbohydrate metabolism in patients with nephrotic syndrome and normal renal function

The effects of a standard oral glucose tolerance test (OGTT) on the serum concentrations of glucose, insulin, growth hormone (GH) and cortisol were evaluated in 38 adult patients with primary nephrotic syndrome and with normal renal function, and in 10 normal subjects. 14 patients had a diabetic-like response and 24 were not different from controls. In both groups of patients an increase in insulin pool secretion, probably due to elevated serum GH levels, was observed. The increased GH values were not related to serum albumin nor to urinary protein losses. No significant difference in serum cortisol values was observed in patients with nephrotic syndrome as compared to controls. There was no strict correlation between the various histologic lesions and the metabolic abnormalities. However, patients with a diabetic-like response to OGTT had a higher frequency of membranous glomerulopathy or focal glomerular sclerosis.