Response of plasma triglycerides to dietary change in patients on hemodialysis.

The effect of reduction in dietary carbohydrate content of meal formula diets on plasma triglyceride concentrations was studied in 12 patients receiving chronic hemodialysis. Fasting plasma triglycerides decreased over a 10-day period in 11 of 12 patients in response to a decreased proportion of carbohydrate (from 50 to 35% of total daily calories) regardless of the type of fat used. Postprandial insulin responses were also significantly lower in the patients on the diets lower in carbohydrate. In addition, triglyceride kinetics were studied in three groups of patients. Patients with renal failure (dialyzed and undialyzed) had lower triglyceride production rates than those of control subjects, despite higher plasma triglyceride concentrations. Elevated (greater than 150 mg/100 ml) fasting plasma triglycerides are associated with lower triglyceride production rates in patients with chronic renal failure and may not be improved by conventional hemodialysis. A long-term study of the efficacy of reduction in dietary carbohydrate on plasma triglycerides is needed since routine hemodialysis does not appear to correct the lipid abnormality in patients with chronic renal failure.