Serum Glucose, Insulin, Growth Hormone, Free Fatty Acids and Lipids Responses to High Carbohydrate and to High Fat Isocaloric Diets in Patients with Chronic, Non-nephrotic Renal Failure

F, Sorge; Castro, Luis Antônio Suíta de; Nagel, Angela; Kessel, Michael

doi:10.1055/s-0028-1093761

Cited by 25 publications

(3 citation statements)

References 20 publications

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“…Both diet and medication are commonly used in the treatment of hyperlipoproteinemia in renal insufficiency. A number of investigators [25,73] showed that simple dietary regimens, e. g. reduction in dietary carbohydrate content and increase in the ratio of polyunsaturated to saturated fatty acids (P/S ratio), are effective in lowering serum triglyceride levels in uremic patients. The respective roles of carbo hydrate reduction and raised P/S ratio remain to be de fined.…”

Section: Therapymentioning

confidence: 99%

Hyperlipoproteinemia in Renal Insufficiency

Heuck

Ritz²

1980

Nephron

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In uremic patients, hyperlipoproteinemia is common, but its role as a risk factor in atherogenesis remains controversial. The main abnormality appears to be diminished catabolism of lipoproteins in the face of unchanged or low hepatic synthesis. The relation of diminished catabolism to reduced postheparin lipolytic activity and selective deficiency of hepatic triglyceride lipase remains to be established. Hyperlipoproteinemia in uremic patients, most commonly of the type IV variety, responds to dietary methods (reduction of carbohydrate content, increase in P/S ratio) or pharmacological intervention. Guidelines for therapy remain controversial in view of the uncertainty about the pathogenic role of hyperlipoproteinemia in atherogenesis.

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Section: Therapymentioning

confidence: 99%

Hyperlipoproteinemia in Renal Insufficiency

Heuck

Ritz²

1980

Nephron

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“…With the carbohydrate-rich diet the TG were higher than with the fat-rich diet. This exacerbation of HL with short-term carbohydrate-rich diets was confirmed in ESRD patients by Sorgeet al [42] and Cattran et al [43].…”

Section: Dietmentioning

confidence: 66%

Therapy for Uremic Hyperlipidemia

Golper¹

1984

Nephron

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Once the decision is made to treat hyperlipidemia in a dialysis patient, several options for therapy are available. This review organizes a therapeutic approach into manipulations primarily by the patient (achievement of ideal body weight, exercise, various diets) and manipulations primarily by the physician. Dialytic options include the composition of the dialysate (buffer, glucose), peritoneal dialysis, hemodialysis and hemofiltration. The roles of dialysis efficiency and heparin are discussed in this context. Medicinal manipulations include drugs to avoid (beta adrenergic blockers, androgens, estrogens, glucocorticoids, ethyl alcohol, diuretics) and specific therapeutic agents (activated charcoal, nicotinic acid, clofibrate, L-carnitine).

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“…Approximately 75% of the dialysate glucose is absorbed in CAPD [15], which, in patients using four 2 litre exchanges per day, amounts to a daily intake of between 80g and 250g of glucose over and above dietary consumption. Two possible consequences of a chronic high carbohydrate intake are obesity and hypertriglyceridaemia, both of which have been described in uraemia [16,17] and in patients on CAPD [18,191. Such effects are important for the long-term well-being of patients on CAPD and may even limit the use of this form of dialysis.…”

Section: Introductionmentioning

confidence: 99%

Carbohydrate and Lipid Metabolism during Continuous Ambulatory Peritoneal Dialysis (CAPD): The Effect of a Single Dialysis Cycle

et al. 1983

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The effect on hormonal status and intermediary metabolism of a single 6 h dialysis cycle at two different concentrations of dialysate glucose was investigated in six patients on continuous ambulatory peritoneal dialysis. The basal blood glucose level was elevated by 0.5 mmol/l, associated with a threefold increase in basal serum insulin compared with seven normal controls. Blood glucose and serum insulin rose further during dialysis, particularly with hypertonic (215 mmol of glucose/l) dialysis fluid and levels remained high for 6 h after the onset. Plasma glucagon concentrations were 2.7-fold increased and did not decrease to normal during dialysis. Concentrations of the gluconeogenic precursors lactate and alanine were consistently raised, and levels of circulating non-esterified fatty acids and ketone bodies were lowered, particularly with hypertonic dialysis fluid. The long-term effects of sustained hyperinsulinaemia, including suppression of lipolysis and ketogenesis, require further investigation.

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Serum Glucose, Insulin, Growth Hormone, Free Fatty Acids and Lipids Responses to High Carbohydrate and to High Fat Isocaloric Diets in Patients with Chronic, Non-nephrotic Renal Failure

Cited by 25 publications

References 20 publications

Hyperlipoproteinemia in Renal Insufficiency

Hyperlipoproteinemia in Renal Insufficiency

Therapy for Uremic Hyperlipidemia

Carbohydrate and Lipid Metabolism during Continuous Ambulatory Peritoneal Dialysis (CAPD): The Effect of a Single Dialysis Cycle

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