Rates of alanine and glucose turnover and precursor-product interrelationships were determined in patients on chronic hemodialysis and in matched controls using simultaneous primed injection-continuous infusions of [U-14C] alanine and [2-3H] glucose. In eight chronically dialyzed patients studied before their first dialysis of the week, glucose turnover was 866 ± 120 μmole/min (mean ± SE); after their last dialysis of the week, glucose turnover was 880 ± 63 μmole/min. These rates were 35% (p < 0.05) and 37% (p < 0.01) greater than rates observed in ten normal volunteers (642 ± 28.3 μmole/min). Fasting glucose and insulin levels in dialyzing patients were unchanged from normal. Alanine turnover was increased predialysis (318 ± 55.2 μmoles/min; p < 0.01) and postdialysis (248 ± 32.4 μmole/min; p < 0.01) as compared to normal (168 ± 14.3 μmole/min). In patients pre- and postdialysis, gluconeogenesis from alanine was increased to 34.6 ± 10.9 μmole/min (p < 0.05) and 39.0 ± 6.33 μmole/min (p < 0.05) compared to 20.9 ± 1.63 μmole/min in normal subjects. We conclude that neither acute nor chronic hemodialysis corrects the increased glucose and alanine production and utilization and gluconeogenesis observed in chronic renal failure.
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism