title: Glucose metabolism and larger molecule removal in long-term high efficiency hemofiltration.
abstract: High efficiency hemofiltration (HF) was carried out for 9 months in 6 patients on hemodialysis (HD). Comparative studies on carbohydrate metabolism and 500- to 1,500-dalton serum solute concentrations were performed during HD and HF. After 5 months of HF, intravenous glucose tolerance tests showed an improved peripheral glucose utilization, with unchanged insulin secretion. Larger solute concentrations, measured by gel chromatography, simultaneously dropped in serum suggesting that HF removes some toxic substances that inhibit peripheral insulin action. After 9 months of HF, an unexpected increase in the larger solute concentration coincided with an impaired glucose tolerance, stressing the probable toxic rule of such solutes. Changes in other glucoregulatory hormone secretions were not unequivocal. On account of the later increase in 500- to 1,500-dalton solute concentrations, HF failed to prevent larger toxic molecules accumulating in uremic sera.
authors.affiliation: Cattedra di Nefrologia, Università di Parma, Italia.
authors.forename: S
authors.initials: S
authors.lastname: David
authors.forename: R
authors.initials: R
authors.lastname: Lugari
authors.forename: G
authors.initials: G
authors.lastname: Rignanese
authors.forename: L
authors.initials: L
authors.lastname: Bonomini
authors.forename: R
authors.initials: R
authors.lastname: Barani
authors.forename: M E
authors.initials: ME
authors.lastname: Ferrari
authors.forename: A
authors.initials: A
authors.lastname: Gnudi
authors.forename: V
authors.initials: V
authors.lastname: Cambi
mesh_terms: D001002:Anuria / Q000097:blood* / Q000628:therapy; D001786:Blood Glucose / Q000032:analysis*; D005934:Glucagon / Q000097:blood; D013006:Growth Hormone / Q000097:blood; D006440:Hemofiltration; D006801:Humans; D007328:Insulin / Q000097:blood; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D008970:Molecular Weight; D011388:Prolactin / Q000097:blood; D006435:Renal Dialysis; D014508:Urea / Q000097:blood
chemical_list: D001786:Blood Glucose; D007328:Insulin; D014508:Urea; D011388:Prolactin; D013006:Growth Hormone; D005934:Glucagon