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Glucose intolerance in children with chronic renal failure
Kidney International. Supplement
|November 1, 1983
Summary
Children with chronic renal failure (CRF) exhibit impaired carbohydrate metabolism, showing glucose intolerance and insulin resistance. These issues worsen with age and correlate with reduced kidney function, highlighting the need for further research into metabolic disturbances in pediatric CRF.
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Metabolic Disorders
Background:
- Chronic renal failure (CRF) in children can significantly impact metabolic processes.
- Understanding carbohydrate metabolism is crucial for managing pediatric CRF complications.
Purpose of the Study:
- To investigate carbohydrate metabolism in children with moderate to severe CRF using the hyperglycemic clamp technique.
- To compare metabolic parameters between children with CRF and healthy controls, considering age and pubertal status.
Main Methods:
- Utilized the hyperglycemic clamp technique to maintain constant hyperglycemia for 120 minutes.
- Measured glucose infusion rate (M) as an index of glucose metabolic rate.
- Assessed insulin response (I) for beta-cell responsiveness and calculated the M/I ratio for insulin sensitivity.
Main Results:
- Children with CRF demonstrated glucose intolerance (lower M), hyperinsulinemia (higher I), and insulin resistance (lower M/I) compared to healthy children.
- Age-related differences were observed, with pubertal children with CRF and adult controls showing lower glucose tolerance and insulin sensitivity.
- Both M and M/I correlated with glomerular filtration rate (GFR) in pubertal children with CRF, and M/I also correlated with GFR in prepubertal children with CRF.
Conclusions:
- The hyperglycemic clamp technique is effective for studying carbohydrate disturbances in pediatric CRF.
- Children with CRF exhibit significant insulin resistance and impaired glucose metabolism, which are linked to disease severity and age.