Inhibition of Postheparin Lipolytic Activity in Uremia and its Relationship to Hypertriglyceridemia 1

Summary

The pathogenesis of hypertriglyceridemia associated with renal failure was studied in 10 non-nephrotic uremic patients undergoing twice-weekly hemodialysis. Fasting plasma triglyceride levels, lipoprotein electrophoretic patterns, and postheparin lipolytic activity (PHLA), using both Ediol and rat chylomicrons as substrate, were determined in each patient. Although PHLA activity was reduced in all patients, serum triglyceride levels were elevated to over 190 mg/100 ml in only six. Plasma from the 10 uremic patients usually inhibited PHLA from normal subjects, but often the degree of inhibition was small and did not correlate with the degree of impairment of PHLA. These results suggest that reduced PHLA may be related in part to a circulating plasma inhibitor, but that factors other than plasma clearance of triglyceride are more important in the development of the hyperlipemia seen in chronic uremia.