腎不全の血液透析療法による膵内分泌機能の変動とその特性に関する研究
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概要
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Metabolic abnormalities of renal failure are considered to be caused by various metabolic inhibitors and/or alteration of endocrinic function. From this viewpoint. the author studied pancreatic secretory furwtions in patients with chronic renal failure and diabetic renal failure through the observation on the effects of hemodialysis treatment, and obtained the following results. 1. In both chronic renal failure and diabetic renal failure, elevation of the blood IRI and IRG value were observed in proportion to proceeding of deteriorioration in renal function. In particular, IRG levels showed positive-correlation with BUN and serum creatinine levels, and negativecorrelation with creatinine clearance. 2. In chronic renal failure patients, the K value of ivGTT decreased in proportion to diminishment of renal function. This K value was improved by hemodialysis treatment. In diabetic renal failure, on the other hand, K value was low and was noted no change by hemodialysis treatment. These appearances of the time courses in this K value also had no relationship with IRG value. Furthermore, the IRG value was observed no correration between with FFA, TG, and cholesterol levels. 3. Though intravenous arginine load showed mild elevation of blood sugar, high IRI and high IRG secretory reactions in both chronic renal failure and diabetic renal failure were observed. These appearances were not shown any changes by hemodialysis treatment. From these results, it is indicated that high IRG level in serum might be derived from hypersecretion in pancreas islets and diminished renal degradation and/or excretion of glucagon.
- 神戸大学の論文