Geronemus R, Bosch J P, Thornton J, Rayfield E J
Arch Intern Med. 1982 Apr;142(4):707-10.
To assess the effects of dialysis or hemofiltration on carbohydrate metabolism in uremia, we performed intravenous (IV) glucose tolerance tests (IV GTTs) after an overnight fast 48 hours following the last treatment in ten patients with chronic renal failure. Samples were obtained for plasma glucose, insulin, glucagon, and growth hormone levels throughout the GTTs in addition to basal samples for levels of plasma potassium and bicarbonate. The IV GTTs were performed at the end of a four-month period of standard hemodialysis (period 1) and then at the end of a four-month period of hemofiltration (period 2). Patients had mild glucose intolerance that did not change after hemofiltration, although the exaggerated insulin responses to glucose administration did significantly decrease in period 2. The fasting hyperglucagonemia did not decrease after hemofiltration but exhibited normal suppression with IV glucose. Levels of basal plasma bicarbonate and basal plasma potassium did not change significantly in period 2. Further studies investigating the beneficial metabolic effect of hemofiltration would seem to be indicated based on the data reported herein.
为评估透析或血液滤过对尿毒症患者碳水化合物代谢的影响，我们在十名慢性肾衰竭患者最后一次治疗48小时后的空腹过夜后进行了静脉葡萄糖耐量试验（IV GTT）。除了采集基础样本检测血浆钾和碳酸氢盐水平外，在整个葡萄糖耐量试验期间还采集样本检测血浆葡萄糖、胰岛素、胰高血糖素和生长激素水平。静脉葡萄糖耐量试验在标准血液透析四个月结束时（第1阶段）进行，然后在血液滤过四个月结束时（第2阶段）进行。患者有轻度葡萄糖不耐受，血液滤过后无变化，尽管在第2阶段对葡萄糖给药的过度胰岛素反应显著降低。空腹高胰高血糖素血症在血液滤过后未降低，但静脉注射葡萄糖后表现出正常抑制。第2阶段基础血浆碳酸氢盐和基础血浆钾水平无显著变化。基于本文报道的数据，似乎需要进一步研究以探讨血液滤过有益的代谢作用。
