Effects of Dietary Modification on The Lipid Metabolism in Patients with Chronic Renal Failure

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  • Tsukamoto Yusuke
    Department of Internal Medicine, Kitasato University School of Medicine
  • Okubo Michito
    Department of Internal Medicine, Kitasato University School of Medicine
  • Marumo Fumiaki
    Department of Internal Medicine, Kitasato University School of Medicine
  • Yoneda Tomiko
    Department of Nutrition, Kitasato University Hospital
  • Arai Shigeru
    Department of Nutrition, Kitasato University Hospital
  • Momma Yasuhiko
    Department of Internal Medicine, Keio University School of Medicine
  • Nakamura Haruo
    Department of Internal Medicine, Jikei-Kai Medical School

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Other Title
  • 慢性腎不全患者における高脂血症―第1報:低含水炭素食の血清トリグリセライド減少効果―
  • マンセイ ジンフゼン カンジャ ニ オケル コウ シケツショウ 1 テイ ガン

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Abstract

Serum lipids were studied in onehundred and two non-nephrotic patients with chronic renal failure (CRF). Serum triglyceride (TG) values (mean ± SD) of the patients with CRF were significantly higher (p<0.001) than those of normal controls (103 ± 35 mg/dl) during both pre-dialysis (144 ± 67 mg/dl) and dialysis (202 ± 107 mg/dl) stages. Elevated serum cholesterol level (237 ± 44 mg/dl versus 193 ± 34 mg/dl of controls) was found in post-transplant patients. Eight pre-dialysis patients were fed carbohydrate-rich (64% of total calories) and .poor (47%) diets, each for one week successively, while maintaining an isocaloric level of 1800 Cal and similar polyunsaturated to saturated fatty acid ratio (0.90 versus 0.76). Mean fasting plasma TG level on the carbohydraterich diet was 158 ± 35 mg/dl and decreased to a mean of 118 ± 24 mg dl on the carbohydrate-poor diet. This difference was significant (p<0.02). However, the plasma hepatic and extra-hepatic post-heparinic lipolytic activities showed constant decreased levels through the diet therapy. In conclusion, hypertriglyceridemia may be due to enhanced TG production caused by carbohydraterich diet, which is customary in these patients, superimposed on potentially defective TG-clearing ability in the patients with CRF.

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