Reduction of plasma triglycerides by diet in subjects with chronic renal failure

The response of plasma triglyceride levels to changes in the composition of meal formula diets was studied in 12 subjects who had moderate to severe chronic renal failure. Fasting hypertriglyceridemia (greater than 150 mg/100 ml) was present in seven of 12 subjects. Fasting plasma triglyceride levels decreased in all subjects in response to a reduction in the proportion of carbohydrate (from 50 to 35% of total daily calories) and an increase in the poly-unsaturated to saturated fat ratio (from 0.2 to 2.0) in an isocaloric diet. Fasting plasma cholesterol and postprandial triglyceride levels were unchanged. Both the triglyceride production rate and the insulin response were significantly lower on a diet in carbohydrate and higher in polyunsaturated fat. These data indicate that hypertriglyceridemia occurs in subjects with moderate to severe chronic renal failure, and that dietary modification promptly reduces triglycerides levels over an 11 day period. A long term study on a dietary program incorporating these changes is indicated to determine whether this effect is sustained.