Abstract
The behavior of patients with lipoid nephrosis to the glucose tolerance test has apparently not been extensively studied. Linder, Hill and Van Slyke 1 in their studies of carbohydrate metabolism in chronic nephritis studied 2 cases but found nothing abnormal in their response to the glucose tolerance test. These observers employed for their tests cutaneous blood obtained by a clean deep prick and made their blood determinations by the method of Hagedorn and Jensen.
We have recently studied the response of 4 patients with typical lipoid nephrosi to the glucose tolerance test and have obtained atypical curves in all these patients. Venous blood was employed for the blood sugar determinations by the method of Folin and Wu. None of these patients showed glycosuria and for this reason only the blood sugar determinations will be reported.
Fig. 1 shows the results of glucose tolerance carried out on the patients employing 1.5 gm. and 3 gm. glucose per kilo body weight. In none of these tests does the blood sugar rise above 0.10 gm. per 100 cc. and we do not see the characteristic sharp peak with rapid fall characteristic of normal individuals.
These patients were placed upon a high carbohydrate diet and treated with diuretics. Following marked clinical improvement, the tests when repeated showed the results charted in Fig. 2. These curves are identical with those of normal individuals.
We have occasionally obtained curves similar to those shown in Fig. 1 in patients with myxedema, mild hyperthyroidism and pituitary disease. Hamman and Hirschman 2 describe a similar curve in a normal control. The presence of such curves in all 4 of these patients with nephrosis is worthy of further study. It is difficult to explain these curves on the basis of a thyroid deficiency.
Get full access to this article
View all access options for this article.