Intravenous fat tolerance test with Intralipid in chronic renal failure

The intravenous fat tolerance test with Intralipid has been used to evaluate the triglyceride (TG) removal capacity in 34 male patients with varying degree of chronic renal failure (CRF). The investigations were repeated in 10 patients after 2-3 years when the renal function had deteriorated further. The fractional removal rate of Intralipid (k2) was low compared to controls, regardless of degree of renal function, etiology of renal disease or treatment with antihypertensive drugs. The k2 value did not change in patients investigated twice, although there was a considerable decrease in renal function. Both in patients and controls there was a strong negative correlation between k2 and the very low density lipoprotein (VLDL) TG concentration. However, at the same k2 value, the VLDL TG concentration was higher in patients than in controls. These data suggest that the hypertriglyceridemia commonly seen in patients with CRF is caused both by an increased VLDL production and a decreased VLDL removal from the circulation. Furthermore, these changes in TG metabolism are induced early in the course of renal insufficiency.