Avram M M, Lipner H I, Sadiqali R, Iancu M, Gan A C
Trans Am Soc Artif Intern Organs. 1976;22:412-9.
By studying the metabolic values of a nondiabetic and diabetic uremic population we demonstrated the following: 1. Insulin is higher in diabetic than nondiabetic uremic patients. A slight arteriovenous difference across the dialyzer membrane suggests that insulin is dialyzable in small amounts in man. 2. C-peptides are highest in nondiabetics, lower in maturity onset diabetics, and lowest in juvenile diabetics. 3. Growth hormone is higher in diabetics than nondiabetics, decreased in both groups during hemodialysis, and returns to pre-dialysis levels 2 hrs after the completion of dialysis treatment. 4. Plasma triglycerides are elevated in both popualtions during the fasting state anddrop during hemodialysis, rising slowly towards the end of hemodialysis. 5. The majority of diabetics on hemodialysis have low renin levels and do not respond to volume reduction. In the high renin diabetics and high and low renin nondiabetics the plasma renin levels rise in response to volume reduction during hemodialysis. Renin is not dialyzable in man. 6. Thyroid function tests show that diabetic and nondiabetic patients have measurements in the low normal range. Our results reveal significant information concerning metabolic changes which take place in diabetic and nondiabetic uremic patients on hemodialysis and helps to characterize these populations. This report may have implications in better understanding the nature of the problems encountered in these populations and in their management (Table III).
通过研究非糖尿病和糖尿病尿毒症患者的代谢值，我们得到了以下结果：1. 糖尿病尿毒症患者的胰岛素水平高于非糖尿病尿毒症患者。透析器膜两侧存在轻微的动静脉差异，这表明胰岛素在人体中可少量被透析。2. C肽在非糖尿病患者中最高，在成年发病型糖尿病患者中较低，而在青少年糖尿病患者中最低。3. 糖尿病患者的生长激素水平高于非糖尿病患者，两组患者在血液透析期间生长激素水平均下降，且在透析治疗结束后2小时恢复到透析前水平。4. 空腹状态下，两组患者的血浆甘油三酯水平均升高，血液透析期间下降，在透析快结束时又缓慢上升。5. 大多数接受血液透析的糖尿病患者肾素水平较低，对血容量减少无反应。在高肾素水平的糖尿病患者以及高肾素和低肾素水平的非糖尿病患者中，血液透析期间血容量减少会导致血浆肾素水平升高。肾素在人体中不可透析。6. 甲状腺功能测试表明，糖尿病和非糖尿病患者的检测结果均处于低正常范围内。我们的研究结果揭示了有关接受血液透析的糖尿病和非糖尿病尿毒症患者代谢变化的重要信息，并有助于对这些人群进行特征描述。本报告可能有助于更好地理解这些人群所遇到问题的本质及其管理方法（表III）。
