Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic Starvation
Severe kidney disease results in retention of uremic toxins that inhibit key enzymes for lipid breakdown such as lipoprotein lipase (LPL) and hepatic lipase (HL). For patients in haemodialysis (HD) and peritoneal dialysis (PD) the LPL activity is only about half of that of age and gender matched con...
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| Format: | Article |
| Language: | English |
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MDPI AG
2014-04-01
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| Series: | Toxins |
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| Online Access: | http://www.mdpi.com/2072-6651/6/5/1505 |
| _version_ | 1818007988941619200 |
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| author | Bernd Stegmayr |
| author_facet | Bernd Stegmayr |
| author_sort | Bernd Stegmayr |
| collection | DOAJ |
| description | Severe kidney disease results in retention of uremic toxins that inhibit key enzymes for lipid breakdown such as lipoprotein lipase (LPL) and hepatic lipase (HL). For patients in haemodialysis (HD) and peritoneal dialysis (PD) the LPL activity is only about half of that of age and gender matched controls. Angiopoietin, like protein 3 and 4, accumulate in the uremic patients. These factors, therefore, can be considered as uremic toxins. In animal experiments it has been shown that these factors inhibit the LPL activity. To avoid clotting of the dialysis circuit during HD, anticoagulation such as heparin or low molecular weight heparin are added to the patient. Such administration will cause a prompt release of the LPL and HL from its binding sites at the endothelial surface. The liver rapidly degrades the release plasma compound of LPL and HL. This results in a lack of enzyme to degrade triglycerides during the later part of the HD and for another 3–4 h. PD patients have a similar baseline level of lipases but are not exposed to the negative effect of anticoagulation. |
| first_indexed | 2024-04-14T05:23:09Z |
| format | Article |
| id | doaj.art-07ec26fa6523476a8d013ddd22721941 |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-04-14T05:23:09Z |
| publishDate | 2014-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-07ec26fa6523476a8d013ddd227219412022-12-22T02:10:06ZengMDPI AGToxins2072-66512014-04-01651505151110.3390/toxins6051505toxins6051505Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic StarvationBernd Stegmayr0Department of Public Health and Clinical Medicine, University of Umeå, Umeå SE-901 87, SwedenSevere kidney disease results in retention of uremic toxins that inhibit key enzymes for lipid breakdown such as lipoprotein lipase (LPL) and hepatic lipase (HL). For patients in haemodialysis (HD) and peritoneal dialysis (PD) the LPL activity is only about half of that of age and gender matched controls. Angiopoietin, like protein 3 and 4, accumulate in the uremic patients. These factors, therefore, can be considered as uremic toxins. In animal experiments it has been shown that these factors inhibit the LPL activity. To avoid clotting of the dialysis circuit during HD, anticoagulation such as heparin or low molecular weight heparin are added to the patient. Such administration will cause a prompt release of the LPL and HL from its binding sites at the endothelial surface. The liver rapidly degrades the release plasma compound of LPL and HL. This results in a lack of enzyme to degrade triglycerides during the later part of the HD and for another 3–4 h. PD patients have a similar baseline level of lipases but are not exposed to the negative effect of anticoagulation.http://www.mdpi.com/2072-6651/6/5/1505hepatic lipaselipoprotein lipasehaemodialysisperitoneal dialysismalnutrition |
| spellingShingle | Bernd Stegmayr Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic Starvation Toxins hepatic lipase lipoprotein lipase haemodialysis peritoneal dialysis malnutrition |
| title | Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic Starvation |
| title_full | Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic Starvation |
| title_fullStr | Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic Starvation |
| title_full_unstemmed | Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic Starvation |
| title_short | Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic Starvation |
| title_sort | uremic toxins and lipases in haemodialysis a process of repeated metabolic starvation |
| topic | hepatic lipase lipoprotein lipase haemodialysis peritoneal dialysis malnutrition |
| url | http://www.mdpi.com/2072-6651/6/5/1505 |
| work_keys_str_mv | AT berndstegmayr uremictoxinsandlipasesinhaemodialysisaprocessofrepeatedmetabolicstarvation |