Skeletal muscle metabolism before and after gemfibrozil treatment in dialysed patients with chronic renal failure.
Patients with chronic renal failure appear at greater risk for skeletal muscle side effects from the fibric acid group of lipid lowering agents. In order to determine whether sub-clinical defects of skeletal muscle metabolism can be detected in dyslipidaemic dialysis-dependent patients receiving fibrates. we studied nine patients before and after three months of gemfibrozil therapy (300-600 mg daily). Aerobic and anaerobic metabolism of the right calf muscle was examined at rest and during exercise using 31P magnetic resonance spectroscopy. Near infra-red spectroscopy was used to assess skeletal muscle re-oxygenation following ischaemic exercise of the arm. Following gemfibrozil treatment plasma triglycerides fell significantly 3.0 +/- 0.5 mM (SEM) to 1.5 +/- 0.2 mM. Gemfibrozil did not affect the established metabolic defects that exist in the skeletal muscle of the dialysed patient. Skeletal muscle re-oxygenation was not significantly lower in renal failure and was not altered by gemfibrozil. Gemfibrozil (600 mg daily) significantly improved the lipid profile of chronic renal failure and was not associated with clinical or bioenergetic impairment of skeletal muscle metabolism.
Thompson
C H
CH
MRC Biochemical and Clinical Magnetic Resonance Unit, John Radcliffe Hospital, Oxford, UK.
Irish
A
A
Kemp
G J
GJ
Taylor
D J
DJ
Radda
G K
GK
D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood; D015444:Exercise; D005260:Female; D015248:Gemfibrozil / Q000627:therapeutic use*; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000187:drug effects / Q000378:metabolism*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D014280:Triglycerides / Q000097:blood
D000960:Hypolipidemic Agents; D014280:Triglycerides; D002784:Cholesterol; D015248:Gemfibrozil