Glucose Metabolism, Lipidic Pattern, Apolipoprotein A and B during Hemodialysis with Cuprophan and Hemodialysis-Hemoperfusion

Abstract

We studied differences in the glucose metabolism, lipid pattern and apolipoprotein A and B after one month of combined hemodialysis-hemoperfusion (HD-HP) in eight regular maintenance hemodialysis (HD) patients. After one month of HD-HP predialytic serum creatinine and phosphate were lower than during the preceding HD period; the lipidic pattern and apolipoproteins were unchanged. A single HD-HP session significantly reduced triglycerides; this does not occur during HD. Postdialytic changes of all other lipoprotein metabolism parameters are identical in the two techniques. As regards glucose metabolism, after one month of regular HD-HP treatment glycemic curves during the intravenous glucose tolerance test (IVGTT) were perfectly matched with those in HD. However, insulin production was lower, with a reduction of the insulin resistance index. Differences did not reach statistical significance. The Authors infer that activated charcoal, even though it achieves better blood purification in uremia, may be unable to remove specific substances which hamper some key enzyme activities of the carbohydrate and lipid metabolism.