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April 1982

Studies of Carbohydrate Metabolism After Hemodialysis and Hemofiltration in Uremic Patients

Author Affiliations

From the Renal and Arteriosclerosis and Metabolism Divisions, Departments of Medicine (Drs Geronemus, Bosch, and Rayfield) and Biostatistics (Dr Thornton), the Mount Sinai School of Medicine of the City University of New York, New York. Dr Geronemus is now with the Florida Medical Center, Lauderdale Lakes.

Arch Intern Med. 1982;142(4):707-710. doi:10.1001/archinte.1982.00340170063014

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.

(Arch Intern Med 1982;142:707-710)