52 research outputs found
Ambulatory Blood Pressure and 10-Year Risk of Cardiovascular and Noncardiovascular Mortality The Ohasama Study
Day-by-Day Variability of Blood Pressure and Heart Rate at Home as a Novel Predictor of Prognosis The Ohasama Study
Plasma Fibrinogen, Ambulatory Blood Pressure, and Silent Cerebrovascular Lesions The Ohasama Study
Expression of Endothelin-1 and Adrenomedullin Was Not Altered by Leptin or Resistin in Bovine Brain Microvascular Endothelial Cells
In Situ Hybridization Method Reveals (Pro)renin Receptor Expressing Cells in the Pituitary Gland of Rats: Correlation with Anterior Pituitary Hormones
Elevated Plasma C-Type Natriuretic Peptide Concentrations in Patients with Chronic Renal Failure
Biochemical evidence of cell starvation in diabetic hemodialysis patients.
Recently, the ratio of patients with diabetes mellitus (DM) among hemodialysis (HD) patients has increased to become the largest sub-population. Their prognoses are significantly worse than those of patients without diabetes (non-DM). In the present study, 10 DM patients who did not take meals and 10 non-DM patients who took meals during HD sessions were investigated. The time courses of the change in plasma levels of metabolites during HD were determined. DM patients exhibited decreased plasma levels of lactate, pyruvate and alanine and dramatically increased levels of ketone bodies. At the end of HD, the plasma levels of lactate, pyruvate, alanine and ketone body were 0.46 ± 0.07, 0.026 ± 0.01, 0.12 ± 0.04 and 0.26 ± 0.04 mM (mean ± standard error), respectively. The profile was 'hypolactatemia and hyperketonemia', indicating non-homeostasis. Glycolysis and tricarboxylic acid cycle were suppressed, and the oxidation of fatty acid was accelerated, indicating starvation, even though high amounts of glucose (150 mg/dl) in dialysate were supplied continuously to the bloodstream. In contrast, the plasma levels of lactate, pyruvate, and alanine in the non-DM patients were increased, with the levels of ketone body remaining low during HD to maintain homeostasis, indicating accelerated glycolysis. Furthermore, their plasma levels of insulin increased from 8.1 ± 1.4 to 19.8 ± 3.4 μU/ml, which indicated endogenous secretion stimulated by glucose in dialysate and meal intake. In contrast, in the DM patients, the levels decreased from 19.2 ± 3.4 to 5.5 ± 1.1 μU/ml. This value was the lower limit of the normal range. The depletion of the insulin through extracorporeal circulation may inhibit the transportation of glucose from the blood into the muscles, with the consequence of cell starvation. Such cell starvation along with lipolysis every two days may accelerate proteolysis and affect the prognosis of DM patients
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