Lipid and carbohydrate metabolism in uraemia

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Abstract
Lipid and carbohydrate metabolism variables were studied in 28 patients with chronic renal failure (mean GFR [glomerular filtration rate] 7.7 .+-. 2.5 ml/min) and uremic symptoms. Of the patients, 71% had hypertriglyceridemia (.ltoreq. 2.2 mmol/l). Total serum cholesterol was normal, while VLDL [very low density lipoprotein] cholesterol was high and .alpha.-lipoprotein [.alpha.-Lp] cholesterol was low. The fractional elimination rate of Intralipid was low and inversely correlated to serum triglyceride levels. I.v. glucose tolerance was reduced with normal or slightly increased fasting blood glucose and insulin values before and during the test. Serum triglycerides were correlated to plasma insulin but not to residual renal function or serum urea levels. The cause of hypertriglyceridemia and lowering of .alpha.-Lp cholesterol is not unequivocally clear. Retarded catabolism of triglyceride-rich lipoproteins may be important, but accentuated release of triglyceride-rich lipoproteins may have occurred in a number of cases. The commonly used treatment with .beta.-blocking agents for hypertension in chronic renal failure may accentuate certain of the metabolic responses in uremia.

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