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Metabolism. 2013 Oct;62(10):1462-9. doi: 10.1016/j.metabol.2013.05.020. Epub 2013 Jul 15.

Acute effects of fructose consumption on uric acid and plasma lipids in patients with impaired renal function.

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1
Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Łódź, Poland.

Abstract

OBJECTIVE:

Metabolic disturbances are common in patients with renal function impairment and are related to high rates of cardiovascular incidents and mortality. Kidney transplantation leads to improved survival but may lead to additional metabolic alterations caused by immunosuppressive drugs and improved nutrition.

MATERIALS AND METHODS:

The short-term effect of oral fructose load on serum uric acid (UA), plasma lipids, and blood pressure (BP) was studied in 85 patients with chronic kidney disease (CKD) and impairment of renal function (glomerular filtration rate 50-65 ml/min per 1.73 m(2)), comprising 55 renal transplant recipients (RTR) treated with standard triple immunosuppressive therapy including a calcineurin inhibitor (CNI) cyclosporine A (CsA) or tacrolimus (Tac) and 30 non-transplanted patients with CKD. Both non-transplanted CKD patients and RTR had stable renal function and a comparable degree of kidney dysfunction. All subjects received orally 70 g of fructose dissolved in 200 ml of water. Serum UA, lipids, and blood pressure were measured at baseline and 60, 120, 180, and 240 minutes after fructose administration.

RESULTS:

There was a significant increase of serum UA concentration (p<0.001) in both CKD patients and RTR--CsA- or Tac-treated patients comparable in the latter. Total cholesterol (TC), LDL, and HDL cholesterol significantly decreased and serum triglycerides (TG) markedly increased in RTR, whereas in CKD patients all serum lipid fractions increased. Blood pressure was unaffected by fructose intake.

CONCLUSION:

Both non-transplanted and transplanted patients with mild renal function impairment show similar acute purine metabolic disturbances following oral administration of fructose but in the latter dietary fructose may induce a smaller hyperlipidemic response.

KEYWORDS:

ADP; AMP; AUC; BMI; BP; C-reactive protein; CKD; CNI; CRP; CVD; Calcineurin inhibitors; Chronic kidney disease; CsA; ESRD; Fructose; GFR; HDL; HDL cholesterol; HFCS; Kidney transplantation; LDL; LDL cholesterol; MAP; MMF; MPA; OFTT; RTR; SCr; TC; TG; Tac; UA; VLDL; adenosine diphosphate; adenosine monophosphate; area under the curve; blood pressure; body mass index; calcineurin inhibitors; cardiovascular disease; chronic kidney disease; cyclosporine A; end-stage renal disease; glomerular filtration rate; high fructose corn syrup; mean arterial pressure; mycophenolate mofetil; mycophenolate sodium; oral fructose tolerance test; renal transplant recipients; serum creatinine; tacrolimus; total cholesterol; triglycerides; uric acid; very low-density lipoprotein

PMID:
23866980
DOI:
10.1016/j.metabol.2013.05.020
[Indexed for MEDLINE]
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