Clinical Investigation

Kidney International (1977) 11, 54–61; doi:10.1038/ki.1977.7

Reduction of plasma triglycerides by diet in subjects with chronic renal failure

Mary L Sanfelippo1, Robert S Swenson1 and Gerald M Reaven1

1Department of Medicine, Stanford University School of Medicine and Veterans Administration Hospital, Palo Alto, California

Correspondence: Dr Mary L Sanfelippo, Veterans Administration Hospital (111-R), 3801 Miranda Avenue, Palo Alto, California 94304, U.S.A.

Received 10 March 1976; Revised 5 August 1976.

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Abstract

Reduction of plasma triglycerides by diet in subjects with chronic renal failure. The response of plasma triglyceride levels to changes in the composition of meal formula diets was studied in 12 subjects who had moderate to severe chronic renal failure. Fasting hypertriglyceridemia (> 150 mg/100 ml) was present in seven of 12 subjects. Fasting plasma triglyceride levels decreased in all subjects in response to a reduction in the proportion of carbohydrate (from 50 to 35% of total daily calories) and an increase in the polyunsaturated to saturated fat ratio (from 0.2 to 2.0) in an isocaloric diet. Fasting plasma cholesterol and postprandial triglyceride levels were unchanged. Both the triglyceride production rate and the insulin response were significantly lower on a diet lower in carbohydrate and higher in polyunsaturated fat. These data indicate that hypertriglyceridemia occurs in subjects with moderate to severe chronic renal failure, and that dietary modification promptly reduces triglyceride levels over an 11 day period. A long term study on a dietary program incorporating these changes is indicated to determine whether this effect is sustained.

Deminution des triglycérides plasmatiques chez les sujets en insuffisance rénale chronique. La réponse des triglycérides plasmatiques aux modifications de la composition des régimes alimentaires a été étudiée chez 12 sujets atteints d'insuffisance rénale chronique modérée ou sévère. Une hypertriglycéridémie à jeun (150 mg/100 ml) existait chez sept parmi les 12 sujets. Les concentrations plasmatiques des triglycérides à jeun ont diminué chez tous les sujets en réponse à la diminution de la proportion d'hydrates de carbone (de 50% à 35% du total des calories) et à l'augmentation du rapport des acides gras non saturés aux acides gras saturés (de 0.2 à 2.0) dans un régime iso-calorique. Le cholestérol plasmatique à jeun et les triglycérides post-prandiaux n'ont pas été modifiés. La production de tryglycérides et la réponse à l'insuline ont été significativement diminuees au cours du regime pauvre en hydrates de carbone. Ces résultats indiquent que l'hypertriglycéridémie survient ches des sujets atteints d'insuffisance rénale chronique modérée on sévère et que les modifications diététiques réduisent rapidement l'hypertriglycéridémie sur une période de 11 jours. Une étude de longue durée d'un programme diététique utilisant ces données est utile pour savoir si l'effet obtenu est durable.

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