This study will evaluate how a common dietary sugar (fructose) raises blood fats (triglycerides). We will determine whether the production of fat from fructose is higher in dialysis patients compared to healthy volunteers. Dialysis patients have high levels of hormone-like substances called cytokines that may increase blood fats. The results will help set better guidelines for diets for the general population and patients with kidney disease who are at high risk for heart attack and stroke. There will be one or two outpatient screening visit(s) and a one-week (6 nights) stay at the Rockefeller University Hospital.
Fifteen hemodialysis patients and 15 healthy volunteers will be studied. Outpatient screening visit(s): consent, fasting blood and urine analysis, a physical exam, an EKG and a 2-hour oral glucose tolerance test to screen for diabetes. Inpatient admission: * Standardized diet that follows the guidelines for hemodialysis patients and healthy volunteers to maintain a stable weight. * Blood and urine sampling. The total amount of blood drawn is less than 1 cup. * To measure the production of fat from fructose, a trace amount of a non-radioactive labeled precursor of fat (13C-acetate) will be infused through a venous catheter for 22 hours. At the end of the infusion, a sweet drink (fructose in 1 ounce of water) will be given orally every half hour for 6 hours. • Two small samples of fat taken right below the skin will be obtained after injection of a small amount of numbing medicine into the abdominal and gluteal regions. Dialysis patients will receive their usual dialysis at The Rogosin Institute Manhattan, Brooklyn or Queens Dialysis Units.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
30
High fat diet: The composition will be: 35% of energy as fat, 50% carbohydrate, 15% protein (\~1.3 g/kg), sat:mono:poly 1:3:1, cholesterol 200 mg/d, 30% starch,15% sugar, 3% fructose, and 25 gm fiber/d. This relatively high fat diet, which falls within the recommendations by the National Kidney Foundation for hemodialysis patients, will suppress fatty acid synthesis in normal volunteers. Fructose in 360 ml water will be orally administered as 1.4 g/kg (\~100 g or 400 kcal for a 70 kg person), divided into 30 mL (1 ounce) doses given every 1/2h for 6 hours.
Rockefeller University Hospital
New York, New York, United States
Peak percent de novo palmitate in blood triglycerides after oral fructose
Time frame: day 1 and day 6
Relationship between TNF and/or its soluble receptors and % newly formed palmitate
Time frame: Day 1 and Day 6
fatty acid composition of TG and adipose tissue
Time frame: Day 1 of hospital admission
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