Glucose metabolism in renal tubular function.

Heterogeneity of metabolic activity along the nephron points to a very varied relationship between glucose metabolism and ion transport. Glycolysis is linked closely to free-water clearance and possibly to sodium, potassium, and hydrogen ion transport. Glucose oxidation, while not the major source of renal energy, is crucial in sodium, potassium, and phosphate reabsorption. Gluconeogenesis recovers carbon compounds generated during the process of renal ammoniagenesis. Glucose synthesis and active sodium transport appear to compete for renal ATP, although no regulatory function for this competition has been identified. Glucose formed in the proximal tubule may support free-water clearance in adjacent distal tubule, but is not thought to contribute to any medullary function. The complex network of biosynthetic and catabolic pathways of glucose metabolism may have evolved in the kidney to protect the organism against wide variations in glucose demand which would otherwise be unavoidable during the course of rapidly fluctuating renal electrolyte loads.