Metabolic effects of hemodialysis with and without glucose in the dialysate.
Metabolic effects of hemodialysis with and without glucose in the dialysate.
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DOI：
10.1038/ki.1993.152
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发表时间：
1993-05
影响因子：
19.6
通讯作者：
Y. Bouffard;S. Tissot;B. Delafosse;J. Viale;G. Annat;O. Bertrand;J. Motin
中科院分区：
文献类型：
--
作者：
Y. Bouffard;S. Tissot;B. Delafosse;J. Viale;G. Annat;O. Bertrand;J. Motin
透析液中含有和不含葡萄糖的血液透析的代谢影响。这项研究在八名接受机械通气的急性肾功能衰竭患者中进行，以测试透析液中添加葡萄糖是否可以防止血液透析引起的代谢和激素变化。使用碳酸氢盐透析液、聚丙烯腈膜和连续肝素化进行血液透析。每个患者进行两次四小时的血液透析：一次没有葡萄糖（GFD），一次在透析液中含有葡萄糖（GD），其浓度接近每位患者的初始血浆葡萄糖浓度。在训练之前、期间和之后测量耗氧量和二氧化碳消除、葡萄糖胰岛素、乙酰乙酸和游离脂肪酸。使用质谱仪的系统测量耗氧量和二氧化碳消除量。血流动力学状态和温度保持恒定。血液透析前，两组的呼吸商（RQ）值相同。 GD期间RQ没有变化。 GFD 期间 RQ 有所下降。 GFD 期间葡萄糖和胰岛素浓度下降，GD 期间保持不变。两种条件下乙酰乙酸浓度保持恒定。 GD和GFD期间游离脂肪酸浓度增加到相同程度。作者得出结论，在透析液中添加葡萄糖可以防止血液透析引起的 RQ 下降。这种效应很可能与非糖化燃料的动员减少有关。
Metabolic effects of hemodialysis with and without glucose in the dialysate. This study was conducted in eight acute renal failure patients undergoing mechanical ventilation to test if the addition of glucose in the dialysate prevents metabolic and hormonal changes induced by hemodialysis. Hemodialysis was performed with a bicarbonate dialysate, a polyacrilonitrile membrane and a continuous heparinization. Two four-hour hemodialysis sessions were performed in each patient: one without glucose (GFD) and one with glucose (GD) in the dialysate at a concentration close to each patient's initial plasma glucose concentration. Oxygen consumption and carbon dioxide elimination, glucose insulin, aceto-acetate and free fatty acids were measured before, during and after the sessions. Oxygen consumption and carbon dioxide elimination were measured with a system using a mass spectrometer. Hemodynamic state and temperature remained constant. Before hemodialysis, respiratory quotient (RQ) values were the same in both groups. There was no change in RQ during GD. There was a decrease in RQ during GFD. Glucose and insulin concentrations decreased during GFD and remained unchanged during GD. Aceto-acetate concentration remained constant under both conditions. Free fatty acids concentration increased to the same extent during GD and GFD. The authors conclude that the addition of glucose in the dialysate prevents the decrease in RQ induced by hemodialysis. This effect is most likely related to a decreased mobilization of non-glucidic fuels.