Tubular reabsorption and urinary excretion of acetoacetate and 3-hydroxybutyrate in normal subjects and juvenile diabetics.

The renal handling of acetoacetate (AA) and 3-hydroxybutyrate (3-HB) has been examined in 8 normal subjects and 7 insulin-treated juvenile diabetics before and after i.v. infusion of sodium DL-3-hydroxybutyrate. In both normals and diabetics and ketone bodies were reabsorbed. At low filtration rates of AA and 3-HB the reabsorption was nearly complete. With increasing filtration rate both the tubular reabsorption rate and the urinary excretion rate of AA and 3-HB increased linearly. A maximal tubular reabsorption rate could not be demonstrated. In spite of higher filtration rates of AA and 3-HB in the diabetics, the mean reabsorption percentage of either ketone body did not differ from that found in the normals.