Effect of protein intake and dialysis on the abnormal growth hormone, glucose, and insulin homeostasis in uremia

Abstract

To evaluate the role of protein intake in the altered growth hormone (GH) secretion of chronic renal failure, GH responses to mild exercise and to an oral glucose tolerance test were measured in ten uremic patients ingesting both low and normal protein diets. To delineate the effect of uremia on any interaction between GH and protein intake, tests were performed before dialysis, after daily dialyses for 3-4 days and after withholding dialysis for 3-4 days. Results were as follows: (1) exercise-stimulated GH release was increased compared to controls; (2) protein intake did not alter GH secretion, (3) basal GH concentrations were significantly correlated with creatinine levels and were significantly lower after dialysis, (4) dialysis did not improve the oral glucose tolerance test, (5) there was no correlation between glucose tolerance and exercise-stimulated GH levels, basal GH concentrations, or the sum of GH values after glucose, and (6) dialysis significantly increased the insulin response to glucose.

Conclusions: In chronic renal failure enhanced GH secretion is not affected by protein intake, does not cause glucose intolerance, and may be related to the degree of uremia. Dialysis does not improve glucose tolerance, but does increase glucose-stimulated insulin release suggesting that insulin antagonism is not ameliorated.