Contribution of dialysate acetate to energy metabolism: Metabolic implications
| Autor: | Brendan P. Teehan, Charles L. Skutches, Miles H. Sigler, George A. Reichard, Joseph H. Cooper |
|---|---|
| Rok vydání: | 1983 |
| Předmět: |
Adult
Male Time Factors Continuous infusion Energy metabolism Acetates Oxygen Consumption Peritoneal Dialysis Continuous Ambulatory Fat oxidation Homeostasis Humans Carbon Radioisotopes Aged Chemistry Carbon Dioxide Middle Aged Molecular biology Solutions Respiratory quotient Biochemistry Nephrology Kidney Failure Chronic Chronic renal failure Female Mass transfer rate Energy Metabolism Oxidation-Reduction Peritoneal Dialysis |
| Zdroj: | Kidney International. 23(1):57-63 |
| ISSN: | 0085-2538 |
| DOI: | 10.1038/ki.1983.11 |
| Popis: | Contribution of dialysate acetate to energy metabolism: Metabolic implications. During hemodialysis large amounts of acetate enter the bloodstream. Generally, it is assumed that this exogenous acetate load is oxidized immediately to carbon dioxide and water; however, the rate of plasma acetate oxidation and the effect of acetate oxidation on energy metabolism during hemodialysis has not been determined previously. The rates of plasma acetate turnover and oxidation were determined during hemodialysis in seven chronic renal failure patients by the primed continuous infusion of [1– 14 C] acetate. The plasma acetate turnover rate (57.2 ± 2.9 µmoles/min · kg) agreed closely with the mass transfer rate of dialysate acetate into the bloodstream (55.3 ± 3.2 µmoles/min · kg). Of the acetate entering the bloodstream, 54.5 ± 5.2% or 31.6 ± 3.77 µmoles/min · kg was oxidized immediately accounting for 40.3 ± 4.8% of the patient's caloric expenditure. Although the oxidation of acetate during dialysis supplied a major portion of the patient's caloric need, a significant quantity of acetate was eliminated by pathways other than direct oxidation. An average overall respiratory quotient (RQ) of 1.0 ± 0.02 indicated that fat oxidation was spared to maintain energy homeostasis during hemodialysis. The calculated nonprotein RQ exceeded unity suggesting that net fat synthesis actually occurred. Contribution d'un dialysat avec acetate au metabolisme energetique: Implications metaboliques. Pendant l'hemodialyse, de grandes quantites d'acetate entrent dans le courant sanguin. On estime en general que cette charge en acetate exogene est immediatement oxydee en dioxyde de carbone et en eau; cependant la vitesse d'oxydation de l'acetate plasmatique et l'effet de l'oxydation de l'acetate sur le metabolisme energetique pendant l'hemodialyse n'ont pas ete determines auparavant. Les vitesses de renouvellement et de l'oxydation de l'acetate plasmatique ont ete determinees pendant l'hemodialyse chez sept malades en insuffisance renale chronique par perfusion continue apres dose de charge de [1– 14 C] acetate. La vitesse de renouvellement de l'acetate plasmatique (57,2 ± 2,9 µmoles/mn · kg) etait en etroite concordance avec la vitesse de transfert massique de l'acetate du dialysat vers le courant sanguin (55,3 ± 3,2 µmoles/mn · kg). De l'acetate entrant dans le courant sanguin, 54,5 ± 5,2% ou 31,6 ± 3,77 µmoles/mn · kg, etaient immediatement oxydes, ce qui representait 40,3 ± 4,8% de la depense calorique du malade. Bien que l'oxydation de l'acetate pendant la dialyse contribue a une tres grande partie du besoin calorique des malades, une quantite significative d'acetate etait utilisee par d'autres voies que l'oxydation directe. Un quotient de la respiration (QR) global moyen de 1,0 ± 0,02 indiquait que l'oxydation des graisses etait epargnee pour maintenir l'homeostasie energetique pendant l'hemodialyse. Le QR nonproteique calcule depassait l'unite, ce qui suggerait qu'une synthese nette de graisse s'est veritablement produite. |
| Databáze: | OpenAIRE |
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