Endocrine Changes in Patients on Chronic Dialysis

Knöchel, James P.

doi:10.1007/978-94-009-6768-7_36

Cited by 5 publications

(4 citation statements)

References 79 publications

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“…Both glucagon and interleukins have to be considered as tentative stimulators of IGFBP-1 production in uraemia. Glucagon increases IGFBP-1 levels when infused into healthy subjects (Hilding et al 1993) and hyperglucagonaemia is a common finding in chronic renal failure (Knochel 1983). Interleukin (IL)-1, IL-6 and tumour necrosis factor alpha (TNF-) stimulate IGFBP-1 release in vitro and administration of IL-6 to mice raises their IGFBP-1 levels (Samstein et al 1996).…”

Section: Discussionmentioning

confidence: 99%

Glutamate concentration in plasma, erythrocyte and muscle in relation to plasma levels of insulin-like growth factor (IGF)-I, IGF binding protein-1 and insulin in patients on haemodialysis

Filho

Hazel²,

Fürst³

et al. 1998

Journal of Endocrinology

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Elevated insulin-like growth factor binding protein (IGFBP) levels, including IGFBP-1, occur in renal failure, and may contribute towards reduced IGF bioactivity in uraemia. The reduced IGF bioactivity may, in turn, contribute towards the disturbances in protein metabolism present in renal failure. In this study, the relationships between intra-and extracellular amino acid (AA) levels and IGF-I and/or IGFBP-1 levels were studied in 30 adult patients (aged 24-70 years) on haemodialysis who had no clinical signs of malnutrition. Blood samples (n=30) and muscle biopsies (n=13) were collected for determination of free AA in erythrocytes (RBC), plasma and muscle by reverse-phase HPLC while IGFBP-1, IGF-I and insulin plasma levels were determined by radioimmunoassay.The patients on haemodialysis had elevated glutamate concentrations in RBC and plasma compared with healthy controls (524 26 vs 448 17 µmol/l, P<0·05 and 45 4 vs 32 4 µmol/l, P<0·01 respectively), although glutamate levels in muscle were within the normal range. The mean IGF-I level was slightly increased (.. score +0·74 0·30) but insulin levels were within the normal range. IGFBP-1 levels, which were inversely correlated to insulin (r= 0·40, P<0·02), were elevated threefold compared with controls. No plasma AA level displayed a significant correlation with IGF-I, IGFBP-1 or insulin levels. However, glutamate concentrations in RBC were positively correlated to IGFBP-1 (r=0·51, P<0·01) and inversely correlated to IGF-I (r= 0·46, P<0·01), although unrelated to insulin. Muscle glutamate, which was inversely related to RBC glutamate, displayed an opposite pattern with an inverse relation to IGFBP-1 levels (r= 0·73, P<0·01) and a positive correlation to IGF-I levels (r=0·64, P<0·02). Glutamate was the only AA to display an inverse correlation between RBC and muscle (r= 0·65, P<0·02, n=12).These findings lead us to propose that, in uraemia, the elevated IGFBP-1 levels, which reduce the bioavailability of IGFs, are linked to glutamate uptake in muscle, resulting in accumulation of RBC glutamate. Whether there is a causal relationship or the correlation is due to some common regulator is not clarified in the present study.

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Section: Discussionmentioning

confidence: 99%

Glutamate concentration in plasma, erythrocyte and muscle in relation to plasma levels of insulin-like growth factor (IGF)-I, IGF binding protein-1 and insulin in patients on haemodialysis

Filho

Hazel²,

Fürst³

et al. 1998

Journal of Endocrinology

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“…In uremia a series of endocrine changes occur [27], Furthermore, clinical studies have suggested that there is accumulation of peptides in serum [28,29]. These changes might have effects on enterocyte growth and differentiation including changes in the expression of brush border enzymes.…”

Section: Discussionmentioning

confidence: 99%

Small Intestinal Peptidases and Disaccharidases in Rats with Acute Uremia

Magnusson

Sjöström²,

Norén³

et al. 1991

Nephron

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Acute uremia was induced in rats with temporary clamping of the left renal pedicle and contralateral nephrectomy. Jejunal peptidase activities (aminopeptidase N, dipeptidyl peptidase IV and aminopeptidase A), disaccharidase activities (maltase, sucrase, lactase and trehalase) and morphology were studied. A significant (p < 0.05) increase in aminopeptidase N activity and a positive correlation between aminopeptidase N activity and serum urea was found in the uremic rats. The other peptidase activities showed a slight increase in the uremic rats. A shortening of the microvilli of the small intestinal epithelial cells in the uremic rats was seen by electron microscopy. The disaccharidase activities were unaltered. This study shows the presence of functional alterations in the small intestine in rats with acute uremia. The observations are also compatible with different regulation mechanisms for the brush border peptidases and disaccharidases.

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“…Binds with specific more often than the general population(10).thyroxine-binding proteins in the Levothyroxine may potentiate the side effects of plasma (which are present in anticoagulants.normal quantities in end-stage renal disease). Binds with specific more often than the general population(10).thyroxine-binding proteins in the Levothyroxine may potentiate the side effects of plasma (which are present in anticoagulants.normal quantities in end-stage renal disease).…”

mentioning

confidence: 99%

Dialyzable Drugs: For CE Credit

Nova¹

1987

The American Journal of Nursing

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Endocrine Changes in Patients on Chronic Dialysis

Cited by 5 publications

References 79 publications

Glutamate concentration in plasma, erythrocyte and muscle in relation to plasma levels of insulin-like growth factor (IGF)-I, IGF binding protein-1 and insulin in patients on haemodialysis

Glutamate concentration in plasma, erythrocyte and muscle in relation to plasma levels of insulin-like growth factor (IGF)-I, IGF binding protein-1 and insulin in patients on haemodialysis

Small Intestinal Peptidases and Disaccharidases in Rats with Acute Uremia

Dialyzable Drugs: For CE Credit

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