LACK OF DIALYZABLE INSULIN ANTAGONIST IN UREMIA

Intravenous glucose tolerance tests were performed on eight uremic patients before and after repeated hemodialyses. Serum was obtained before each test for use in an in vitro rat hemidiaphragm assay specifically designed to measure insulin antagonism. With this modification, the activity of insulin added to the pre- and post-dialysis sera of the same patient can be compared on the tissues from one rat, thus eliminating variation between animals. Although glucose tolerance improved in every patient (p < .005), there was no difference in the activity of insulin added to sera collected before and after treatment. It is concluded that glucose intolerance in uremia is probably not due to a dialyzable insulin antagonist but is caused by an insensitivity of the peripheral tissues secondary to the metabolic changes of renal failure. © 1969.