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Lactate metabolism in acute uremia
Xavier Leverve1, Iqbal Mustafa, Ivan Novak
1Laboratoire de Bioénergétique Fondamentale et Appliquée, University Joseph Fourier, Grenoble, France. Xavier.Leverve@ujf-grenoble.fr <Xavier.Leverve@ujf-grenoble.fr>
Summary
Exogenous lactate is well metabolized in patients with acute renal failure and severe sepsis. This finding suggests that lactate-containing fluids can be safely used in these critically ill patients, challenging previous concerns.
Area of Science:
- Biochemistry
- Critical Care Medicine
- Nephrology
Background:
- Lactate is a crucial metabolite involved in cellular energy homeostasis and redox balance.
- While often an indicator of poor outcomes, lactate itself may have beneficial roles in metabolic disorders.
- The kidney, alongside the liver, plays a vital role in maintaining lactate homeostasis and the glucose-lactate cycle.
Purpose of the Study:
- To investigate the metabolism of exogenous lactate in critically ill patients with acute renal failure and severe sepsis.
- To determine if exogenous lactate administration impacts endogenous lactate production and metabolism in this patient population.
Main Methods:
- Study focused on severe septic patients experiencing acute renal failure.
- An acute exogenous lactate load was administered.
- Endogenous lactate production and metabolism were monitored.
Main Results:
- Exogenous lactate administration did not alter basal endogenous lactate production.
- Exogenous lactate was effectively metabolized even in patients with acute renal failure and severe sepsis.
- Hemodynamic status did not impede exogenous lactate metabolism.
Conclusions:
- Exogenous lactate is well-tolerated and metabolized in patients with acute renal failure and severe sepsis.
- Lactate-containing fluids may be safely utilized in these complex patient cases.
- Concerns regarding lactate metabolism limitations in acute renal failure and sepsis may be overstated.