Gluconeogenesis and sodium transport are ATP-requiring functions of the renal proximal tubule. Previously observed interactions between these processes indicated that they may compete for cellular energy. We have reevaluated this interaction in the rabbit proximal tubule using two preparations: suspensions of cortical tubules and isolated perfused tubules. In the presence of lactate and alanine, net glucose synthesis was 22.3 +/- 1.3 nmol X mg protein-1 .30 min-1. Additions of valerate, butyrate, or succinate increased this rate by factors of 2-3 without affecting cellular ATP levels or net fluid absorption (Jv). Inhibition of ATP production with rotenone, which we have previously shown to inhibit Jv [Am. J. Physiol. 243 (Renal Fluid Electrolyte Physiol. 12): F133-F140, 1982], greatly decreased the gluconeogenic rate, but this was modulated by the type of gluconeogenic substrate used. Increasing Na-K-ATPase activity with nystatin or decreasing it with ouabain had widely differing effects, which also depended on the substrate regimen. We conclude that the interaction between gluconeogenesis and active sodium transport cannot be described by a simple competition for ATP. Rather, under normal circumstances, the renal proximal tubule can meet the energetic demands of both gluconeogenesis and sodium transport, and control of these processes is multifactorial and sensitive to fatty acid metabolism.
The Effects of Insulin Resistance and Inflammation on Renal Proximal Tubule Sodium Transport and Hypertension