Impaired plasma triglyceride clearance as a feature of both uremic and posttransplant triglyceridemia

After accurate plasma volume calculation, endogenous plasma very-low-density-lipoprotein (VLDL)-triglyceride turnover rates were measured in 20 undialyzed patients with chronic renal failure (CRF) and in 16 renal transplant recipients with stable graft function. When kinetic criteria were based on a group of healthy subjects (Vmax = 36.7 mumoles/hr/kg), it was clear that, on the whole, CRF patients had a reduced capacity for VLDL-triglyceride removal (Vmax = 14.0 mumoles/hr/kg), as did graft recipients (Vmax = 19.5 mumoles/hr/kg). In transplant recipients with impaired graft function, however, extremes of both under removal and over production of VLDL-triglycerides were observed. In CRF, defective clearance was accompanied by a reduction in postheparin lipoprotein and hepatic lipase activities, although there was no statistical relationship. Enzyme activities were not reduced, however, after transplantation, and the metabolic factors responsible for defective clearance were not clearly identified.