Abstract
Effect of hemodialysis on insulin receptor binding of erythrocytes was studied in chronic renal failure patients with diapetes (DN, n=7) or without diabetes (ND, n=7). There was a significant decrease in insulin binding before hemodialysis in both groups compared with healthy controls [DN: 3.4±0.5, ND: 4.2±0.8 vs N/C: 7.9±0.4%(p<0.05)]. In the DN group, there was a significant increase in insulin binding after hemodialysis [3.4±0.5% vs 5.8±0.8%(p<0.05)]. Scatchard analysis indicated that this change was due to an increase in the affinity of receptors for insulin.
To investigate the mechanism of change in insulin receptor binding in uremia, in vitro incubation studies with uremic serum or methylguanidine (MG) were carried out. Insulin binding was decreased in a dose-dependent manner at a MG concentration ranging from 10 to 100 ng/ml. There was a tendency for improvement in insulin binding 12 hours after elimination of MG from the medium (from 81±6% to 83±8%). In the uremic serum experiments, insulin binding increased significantly 12 hours after elimination of serum from the incubation medium [from 69±2% to 78±3%(p<0.05)].
These results suggest that some factors, such as MG, in uremic serum have inhibitory effects on insulin receptor binding.
