Carbohydrate and lipid metabolism during continuous ambulatory peritoneal dialysis (CAPD): the effect of a single dialysis cycle.
The effect on hormonal status and intermediary metabolism of a single 6 h dialysis cycle at two different concentrations of dialysate glucose was investigated in six patients on continuous ambulatory peritoneal dialysis. The basal blood glucose level was elevated by 0.5 mmol/l, associated with a threefold increase in basal serum insulin compared with seven normal controls. Blood glucose and serum insulin rose further during dialysis, particularly with hypertonic (215 mmol of glucose/l) dialysis fluid and levels remained high for 6 h after the onset. Plasma glucagon concentrations were 2.7-fold increased and did not decrease to normal during dialysis. Concentrations of the gluconeogenic precursors lactate and alanine were consistently raised, and levels of circulating non-esterified fatty acids and ketone bodies were lowered, particularly with hypertonic dialysis fluid. The long-term effects of sustained hyperinsulinaemia, including suppression of lipolysis and ketogenesis, require further investigation.
D000328:Adult; D000368:Aged; D000409:Alanine / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002241:Carbohydrates / Q000097:blood*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005934:Glucagon / Q000097:blood; D005990:Glycerol / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D007657:Ketone Bodies / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood*; D007773:Lactates / Q000097:blood; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011773:Pyruvates / Q000097:blood
D001786:Blood Glucose; D002241:Carbohydrates; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D007657:Ketone Bodies; D007773:Lactates; D008055:Lipids; D011773:Pyruvates; D005934:Glucagon; D000409:Alanine; D005990:Glycerol