Anna Zawiasa1, Michał Nowicki. 1. Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Łódź, Poland.
Abstract
OBJECTIVE: Metabolic disturbances are common in patients with renal function impairment and are related to high rates of cardiovascular incidents and mortality. Kidney transplantation leads to improved survival but may lead to additional metabolic alterations caused by immunosuppressive drugs and improved nutrition. MATERIALS AND METHODS: The short-term effect of oral fructose load on serum uric acid (UA), plasma lipids, and blood pressure (BP) was studied in 85 patients with chronic kidney disease (CKD) and impairment of renal function (glomerular filtration rate 50-65 ml/min per 1.73 m(2)), comprising 55 renal transplant recipients (RTR) treated with standard triple immunosuppressive therapy including a calcineurin inhibitor (CNI) cyclosporine A (CsA) or tacrolimus (Tac) and 30 non-transplanted patients with CKD. Both non-transplanted CKD patients and RTR had stable renal function and a comparable degree of kidney dysfunction. All subjects received orally 70 g of fructose dissolved in 200 ml of water. Serum UA, lipids, and blood pressure were measured at baseline and 60, 120, 180, and 240 minutes after fructose administration. RESULTS: There was a significant increase of serum UA concentration (p<0.001) in both CKD patients and RTR--CsA- or Tac-treated patients comparable in the latter. Total cholesterol (TC), LDL, and HDL cholesterol significantly decreased and serum triglycerides (TG) markedly increased in RTR, whereas in CKD patients all serum lipid fractions increased. Blood pressure was unaffected by fructose intake. CONCLUSION: Both non-transplanted and transplanted patients with mild renal function impairment show similar acute purine metabolic disturbances following oral administration of fructose but in the latter dietary fructose may induce a smaller hyperlipidemic response.
OBJECTIVE: Metabolic disturbances are common in patients with renal function impairment and are related to high rates of cardiovascular incidents and mortality. Kidney transplantation leads to improved survival but may lead to additional metabolic alterations caused by immunosuppressive drugs and improved nutrition. MATERIALS AND METHODS: The short-term effect of oral fructose load on serum uric acid (UA), plasma lipids, and blood pressure (BP) was studied in 85 patients with chronic kidney disease (CKD) and impairment of renal function (glomerular filtration rate 50-65 ml/min per 1.73 m(2)), comprising 55 renal transplant recipients (RTR) treated with standard triple immunosuppressive therapy including a calcineurin inhibitor (CNI) cyclosporine A (CsA) or tacrolimus (Tac) and 30 non-transplanted patients with CKD. Both non-transplanted CKDpatients and RTR had stable renal function and a comparable degree of kidney dysfunction. All subjects received orally 70 g of fructose dissolved in 200 ml of water. Serum UA, lipids, and blood pressure were measured at baseline and 60, 120, 180, and 240 minutes after fructose administration. RESULTS: There was a significant increase of serum UA concentration (p<0.001) in both CKDpatients and RTR--CsA- or Tac-treated patients comparable in the latter. Total cholesterol (TC), LDL, and HDL cholesterol significantly decreased and serum triglycerides (TG) markedly increased in RTR, whereas in CKDpatients all serum lipid fractions increased. Blood pressure was unaffected by fructose intake. CONCLUSION: Both non-transplanted and transplanted patients with mild renal function impairment show similar acute purine metabolic disturbances following oral administration of fructose but in the latter dietary fructose may induce a smaller hyperlipidemic response.
Authors: Rafał Donderski; Ilona Miśkowiec-Wiśniewska; Marek Kretowicz; Magdalena Grajewska; Jacek Manitius; Anna Kamińska; Roman Junik; Joanna Siódmiak; Anna Stefańska; Grażyna Odrowąż-Sypniewska; Agnieszka Pluta; Miguel Lanaspa; Richard J Johnson Journal: BMC Nephrol Date: 2015-05-03 Impact factor: 2.388