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Uremic hyperlipoproteinemia: correlation with residual renal function and duration of maintenance hemodialysis
Insights
In renal failure, elevated plasma triglyceride is common, appearing when glomerular filtration rate (GFR) drops to 50 ml/min and worsening at lower GFR. Cholesterol levels remain normal, but hormone changes occur without clear GFR correlation.
Area of Science:
- Nephrology
- Endocrinology
- Clinical Chemistry
Background:
- Renal failure is associated with various metabolic disturbances.
- Lipid abnormalities are frequently observed in patients with chronic kidney disease.
Purpose of the Study:
- To investigate the relationship between glomerular filtration rate (GFR) and plasma lipid levels in renal failure.
- To examine the correlation between GFR and levels of growth hormone, glucagon, and insulin.
Main Methods:
- Plasma triglyceride, cholesterol, growth hormone, glucagon, and insulin levels were measured.
- Patients with varying degrees of renal function, including those on maintenance hemodialysis, were studied.
- Correlation analysis between hormone levels and GFR was performed.
Main Results:
- Elevated plasma triglyceride was detected when GFR fell to 50 ml/min.
- Hypertriglyceridemia worsened as GFR decreased below 10 ml/min.
- Plasma cholesterol levels remained normal across different stages of renal function.
- Elevated growth hormone, glucagon, and insulin levels were observed in diminished renal function, but without a definite correlation with GFR.
Conclusions:
- Hypertriglyceridemia is a common lipid abnormality in renal failure, directly related to GFR.
- Plasma cholesterol is not significantly affected by reduced renal function.
- Hormonal changes in renal failure do not directly correlate with GFR, but may influence lipid profiles.
Abstract:
Our study indicates that in renal failure elevated plasma triglyceride can first be detected when the GFR falls to 50 ml/min. Hypertriglyceridemia is the commonest abnormality found and increases further when the GFR falls below 10 ml/min. Plasma cholesterol levels remain normal even at low levels of renal function. Although plasma growth hormone, glucagon, and insulin levels become elevated when renal function diminishes, there is no definite correlation of their levels and GFR. A decreased incidence of hyperlipidemia observed in patients sustained by maintenance hemodialysis for over 5 yrs may in part be due to the triglyceride lowering effect of growth hormone and glucagon and/or the cholesterol lowering effect of insulin.