Abstract
Plasma lipids fractions (cholesterol, triglyceride, β-lipoprotein, phospholipid and free fatty acids), postheparin lipolytic activity (PHLA) and immunoreactive insulin (IRI) were examined in 25 uremic patients undergoing intermittent hemodialysis over 6 years in duration. 1) Patients with 3 years hemodialysis (n=13) and 4 years hemodialysis (n=9) showed significantly increased triglyceride levels. Cholesterol did not change significantly and showed lower levels in those patients than control. Phospholipid had little changes within normal limit. β-Lipoprotein was normal, but slightly increased in patients with 6 years hemodialysis. Free fatty acids (FFA) level was significantly high throughout this study. However, patients with 5 and 6 years hemodialysis revealed rather low levels in IRI, compared to those of the early period of hemodialysis. 2) Any significant correlations between triglyceride, BUN, IRI, S-albumin and PHLA were not seen in the study. 3) In 12 patients with 4 years hemodialysis, the effect of hemodialysis to plasma lipids, PHLA and IRI was observed. None of these paramenters did not show any significant changes at the end of hemodialysis and the following morning. 4) The supplemental high caloric diet was given at every lunch time of each hemodialysis for 9 months. Triglyceride, phospholipid, FFA and β-lipoprotein significantly increased compared to the value of control and/or the value before starting this supplemental diet. 5) From this study, it can be assumed that low level of PHLA, as a cause of delayed clearing of triglyceride from blood and high level of IRI, as a cause of increased generation of triglyceride in liver, were indirectly related to the control of plasma triglyceride level in patients undergoing maintenance hemodialysis. Additionaly, a high caloric diet for hemodialyzed patients may contribute to high levels of plasma triglyceride and FFA.
