Figure 1816

Lipid metabolism in acute renal failure (ARF). Profound alterations of lipid metabolism occur in patients with ARF. The triglyceride content of plasma lipoproteins, especially very low-density (VLDL) and low-density ones (LDL) is increased, while total cholesterol and in particular high-density lipoprotein (HDL) cholesterol are decreased [33,34]. The major cause of lipid abnormalities in ARF is impairment of lipolysis. The activities of both lipolytic systems, peripheral lipoprotein lipase and hepatic triglyceride lipase are decreased in patients with ARF to less than 50% of normal [35].

Maximal postheparin lipolytic activity (PHLA), hepatic triglyceride lipase (HTGL), and peripheral lipoprotein lipase (LPL) in 10 controls (open bars) and eight subjects with ARF (black bars). However, in contrast to this impairment of lipolysis, oxidation of fatty acids is not affected by ARF. During infusion of labeled long-chain fatty acids, carbon dioxide production from lipid was comparable between healthy subjects and patients with ARF [36]. FFA—free fatty acids. (Adapted from Druml et al. [35]; with permission.)

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