A RELATIONSHIP BETWEEN THE CARBONHYDRATE METABOLISM AND PARATHYROID HORMONE LEVELS IN CHRONIC RENAL FAILURE

Some degree of glucose intolerance develops in all patients with chronic renal failure. The present study was designed to investigate the effect of Parathyroid hormone (PTH) on peripheral glucose metabolism of patients with chronic renal failure (CRF). Twenty-two patients with CRF (Group 1:11 patients with GFR: 10-25 ml/min) and Group 2:11 patients with GRF 26-50 ml/min) and 10 normal subjects were studied after overnight fast and 4 h after ingestion of 75 gr of glucose. Serum glucose levels at 60 lh , 120 th and 240 th min. and serum PTH and insulin levels at 60th and 120th min were measured. Also area under the curves (AUC) were calculated according to mean glucose and insulin levels in all groups. Kruskal-Wallis nonpar ametric test and Pearson correlation test were used for compare the groups. In group 1 and group 2, glucose (p: 0,02) and insulin (p: 0,04) levels were found significantly higher than controls. In group 1, the increment of serum PTH levels (r: 0.45, p< 0,05) and decrement of GFR (r: -0.51 ,p<0,05) and in group 2 the increment of PTH levels (r: 0,54, p<0,05) were found as the cause of glucose intolerance and hyperinsulinism. These data demonstrate that chronic uraemia causes insulin resistance. As elevated PTH levels impaired insulin secretion, it compromise the ability of pancreas to maintain normal glucose homeostasis and an abnormal glucose tolerance will result.