Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Jan 21, 2019; 8(1): 11-22
Published online Jan 21, 2019. doi: 10.5527/wjn.v8.i1.11
Insulin receptors in the kidneys in health and disease
Sarojini Singh, Rajni Sharma, Manju Kumari, Swasti Tiwari
Sarojini Singh, Rajni Sharma, Manju Kumari, Swasti Tiwari, Department of Molecular Medicine and Biotechnology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
Author contributions: Singh S and Tiwari S contributed to the conception of the review; Singh S, Sharma R, Kumari M, and Tiwari S performed literature search, drafting, and editing of the review; all authors approved the final version of the manuscript for submission.
Supported by Department of Biotechnology, Ministry of Science and Technology, India and Ramalingaswami Grant, No. BT/HRD/35/02/17/2008 (to Tiwari S); Fellowships from Council of Scientific and Industrial Research, India, No. 09/590/(0159)/2016-EMR-1 (to Sharma R) and No. 09/590/(0156)/2014-EMR-1 (to Kumari M).
Conflict-of-interest statement: All authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Swasti Tiwari, PhD, Professor, Department of Molecular Medicine and Biotechnology, Sanjay Gandhi Postgraduate Institute and Chair of Medical Sciences, Lucknow 226014, India.
Telephone: +91-522-2495642
Received: September 28, 2018
Peer-review started: September 28, 2018
First decision: October 26, 2018
Revised: November 15, 2018
Accepted: December 10, 2018
Article in press: December 10, 2018
Published online: January 21, 2019

Insulin is an important hormone that affects various metabolic processes, including kidney function. Impairment in insulin’s action leads to insulin resistance in the target tissue. Besides defects in post-receptor insulin signaling, impairment at the receptor level could significantly affect insulin sensitivity of the target tissue. The kidney is a known target of insulin; however, whether the kidney develops “insulin resistance” is debatable. Regulation of the insulin receptor (IR) expression and its function is very well studied in major metabolic tissues like liver, skeletal muscles, and adipose tissue. The physiological relevance of IRs in the kidney has recently begun to be clarified. The credit goes to studies that showed a wide distribution of IR throughout the nephron segments and their reduced expression in the insulin resistance state. Moreover, altered renal and systemic metabolism observed in mice with targeted deletion of the IR from various epithelial cells of the kidney has strengthened this proposition. In this review, we recapitulate the crucial findings from literature that have expanded our knowledge regarding the significance of the renal IR in normal- and insulin-resistance states.

Keywords: Insulin receptor, Insulin resistance, Kidney disease, Renal sodium reabsorption, Gluconeogenesis, Proteinuria, Systemic blood pressure

Core tip: Dysregulation of the renal insulin receptor (IR) not only affects local renal metabolism, but also disturbs the systemic glucose homeostasis and blood pressure, leading to metabolic abnormalities. The objective of this review is to highlight the pathophysiological stature of renal IRs in the kidney function, as well as, overall metabolism.