Effect of dialysis treatment on glucose metabolism in uremic patients

To study the carbohydrate metabolism in uremic patients, the intravenous glucose tolerance test (iv GTT) and insulin sensitivity test were investigated on 69 patients with chronic renal failure, 27 of whom were under the dialysis treatment. 1) Abnormal K-values averaging 1.05 were obtained in uremic patients (creatinine clearance less than 20 ml/min). 2) Carbohydrate intolerance in uremic patients was corrected with regular dialysis and the improvement was correlated with the duration of dialyses. 3) The mechanisms of improvement in carbohydrate metabolism were different between the short-term dialysis group (less than 12 months of dialysis) and the long-term group (more than 12 months). Enhanced secretion of insulin seemed to be the main cause of this improvement in the former, while the correction of impaired sensitivity to insulin in peripheral tissues in the latter.