Chronic renal failure is one of the chronic life threatening diseases affecting
human beings. Abnormalities in carbohydrate metabolism have
been recognized in non diabetic uremic patients with end stage renal disease
(ESRD) . Patients undergoing regular hemodialysis usually develop
hypoglycaemic symptoms during the dialysis session .We studied the effects
of hemodialysis on the serum insulin level in these patients .
Analysis of the data obtained from our study revealed, that, there is a
significant increase in blood glucose levels and serum insulin level in
uremics compared to controls . Also serum insulin level was high in hemodialysis
uremics before and after dialysis compared to those on conservative
treatment. These abnormalities may be contributed to many factors:
such as:
* Inability of the diseased kidney & the skeletal muscles to degrade insulin.
* Suppression of insulin' binding to erythrocytes of predialysed plasma.
* Augmented gluconeogenesis.
* Increased potassium level.
* Metabolic acidosis.
'Increased receptor binding of glucagon
Also, our study showed a significant decrease in serum insulin level
after dialysis session but not to the normal values, which may be due to
removal of unidentified small and rnidlle molecular weight peptides from
the uremic patient's plasma by dialysis which is supposed to be responsible
for the uremic toxicity and insulin resistance in the peripheral tissues. |
